1. ECOWATCH CUSTOMER’S INFORMATION SHEET
Account Code:____________
1. COMPANY IDENTIFICATION
Name of Client:
Address:
Telephones No. (s)
11. LINE OF BUSINESS
• Industrial Lightings
• Hospital/Clinic
• Food Manufacturing
• Constructions
• Manufacturing
111. TYPE OF ORGANIZATION
□Single Proprietorship Partnership Organization Corporation
DTI REG NO._______________ TIN NO:_______________
SEC REG NO._______________ Date Organized: ________________
1V. PRINCIPAL OWNERS/OFFICERS: (Name and Position)
1.______________________________________________
2.______________________________________________
3:______________________________________________
4.______________________________________________
V. BANK REFERENCE
Bank Name: Branch:
Contact Person:__________________ Tel.No.:
Bank Name:______________________________ Branch:_________________________
Contact Person:___________________________ Tel.No.:_________________________
VI. MAJOR SUPPLIERS
Supplier Name:__________________________ Address:________________________
Contact Person:__________________________ Tel.No.:_________________________
Supplier Name:___________________________ Address:_________________________
Contact Person:___________________________Tel.No.:_________________________
VII. NAME AUTHORIZED TO SIGN PURCHASE ORDER
1._________________________________________________________________________________
2.________________________________________/_________________________________________
VIII. NAME OF PERSON(S) IN-CHARGE OF CHECK RELEASING/COLLECTION
1.________________________________________________________________________________
2.________________________________________________________________________________________
We hereby certify that the fact are true and correct and we further undertake to notify Ecowatch of any changes
thereto.

2. Authorized Officer ( Signature over Printed Name) Position Date
DO NOT FILL BELOW THIS LINE (For Ecowatch use only)
Remarks:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________ SALES REPRESENTATIVE
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
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