Buyer'S Information Sheet: Required Required

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BUYER'S INFORMATION SHEET

Kindly fill-out all fields and indicate "NA" to fields not applicable.
Penthouse Building II, Sta. Lucia East Grand Mall, Marcos Highway corner Felix Avenue, Cainta Rizal, Philippines, 1900
Telephone 722 5811, (229) | Fax 722 5022 | Website http://www.staluciarealty.com
PROJECT: LOCATION / OWNER: TYPE OF PROPERTY: LOT / UNIT DETAILS:
AREA/PRICE PER.SQ M.: TOTAL CONTRACT PRICE: PAYMENT TERM:
PURPOSE OF PURCHASE PRIMARY RESIDENCE SECONDARY RESIDENCE OTHERS, SPECIFY
TERTIARY RESIDENCE INVESTMENT
THE BUYER DESIRES THE PURCHASE TO BE REGISTERED AS: SOLE MARRIED SPOUSES CORPORATION PARTNERSHIP
PRINCIPAL BUYER'S INFORMATION
FIRST NAME * Required MIDDLE NAME LAST NAME * Required

DATE OF BIRTH: CIVIL STATUS * Required SINGLE MARRIED WIDOWER/WIDOW


TIN: * Required CITIZENSHIP * Required SEX: MALE FEMALE
PASSPORT NO. / PLACE / DATE ISSUED / EXPIRATION DATE * Required GOVT. ISSUED ID NO., ID NAME (TIN NUMBER/ DRIVER'S LICENSE/ SSS/GSIS, etc.) * Required

PERMANENT RESIDENCE ADDRESS IN THE PHILIPPINES * Required

PROVINCIAL ADDRESS

OWNERSHIP OF CURRENT RESIDENCE: OWNED RENTED LIVING WITH RELATIVES MORTGAGED YEARS OF RESIDENCY:
RESIDENCE TELEPHONE NO. * Required MOBILE NO. * Required PERSONAL E-MAIL ADDRESS

EMPLOYMENT TYPE (Primary Source of Income) * Required PROPRIETOR LOCALLY EMPLOYED OVERSEAS CONTRACT WORKER
BUSINESS / EMPLOYER'S NAME:
OFFICE ADDRESS

* Required
INDUSTRY: RANK / POSITION: YEARS IN SERVICE:
OFFICE TELEPHONE NO. OFFICE FAX NO. OFFICE E-MAIL ADDRESS GROSS MONTHLY INCOME

SPOUSE / CO-BUYER'S INFORMATION


FIRST NAME MIDDLE NAME LAST NAME

TIN: CITIZENSHIP: SEX MALE FEMALE


DATE OF BIRTH: RELATIONSHIP TO BUYER: CIVIL STATUS: SINGLE MARRIED WIDOWER/WIDOW
PASSPORT NO. / PLACE / DATE ISSUED / EXPIRATION DATE:
PERMANENT RESIDENCE ADDRESS IN THE PHILIPPINES

RESIDENCE TELEPHONE NO. MOBILE NO. PERSONAL E-MAIL ADDRESS

EMPLOYMENT TYPE: PROPRIETOR LOCALLY EMPLOYED OVERSEAS CONTRACT WORKER


BUSINESS / EMPLOYER'S NAME:
OFFICE ADDRESS

OFFICE TELEPHONE NO. OFFICE FAX NO. OFFICE E-MAIL ADDRESS GROSS MONTHLY INCOME

ATTORNEY-IN-FACT (for buyers abroad) Please attach notarized Special Power of Attorney (SPA)
FIRST NAME MIDDLE NAME LAST NAME

RESIDENCE TELEPHONE NO. MOBILE NO. PERSONAL E-MAIL ADDRESS

SPA's POSTAL / MAILING ADDRESS

TIN: CITIZENSHIP: SEX: MALE FEMALE


DATE OF BIRTH: RELATIONSHIP TO BUYER: CIVIL STATUS: SINGLE MARRIED WIDOWER/WIDOW

I/We hereby certify that all information indicated in the Buyer's Information
Sheet are valid, true, correct, and complete and that the signature/s appearing
herein belong/s to me/us and is/are genuine and binding upon me/us. _______________________________________________
PRINCIPAL BUYER (signature over
printed name with date)

I/We hereby authorize Sta. Lucia Realty & Development, Inc. and its internal
and external representatives to obtain any information from and/or conduct _______________________________________________
independent verification of information provided by me/us in connection with this SPOUSE / CO-OWNER (signature over
purchase with other institution/third person. I/We expressly consent to the printed name with date)
disclosure of such institution/third person to Sta. Lucia Realty & Development,
Inc. and its representatives of any such information and I/We hereby expressly
waive any and all of my/our rights under applicable laws relative to the _______________________________________________
confidentiality of such information. ATTORNEY IN FACT (signature over
printed name with date)

I/We understand that the approval of this purchase is solely discretionary upon
Sta. Lucia Realty & Development, Inc. and that non disclosure/falsification of
information as herein required shall be sufficient ground for disapproval of
my/our purchase and/or privileges. DATE: ________________________________

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