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    Prudential Guarantee and Assurance Inc.: Client Information Sheet - For Individual Client

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    Ryan Redoble Delmo
    This 3 sentence summary provides the key details about the client information sheet document: The document is a client information sheet for Prudential Guarantee and Assurance Inc. that collects personal details such as name, address, contact information, identification numbers, employment details, source of funds, and beneficiary names for individual clients. Upon completion, the client signs and dates the form which is then filled out by Prudential Guarantee with the client's assured code and intermediary.

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    © All Rights Reserved
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    Prudential Guarantee and Assurance Inc.: Client Information Sheet - For Individual Client

    Uploaded by

    Ryan Redoble Delmo
    194 views1 page
    This 3 sentence summary provides the key details about the client information sheet document: The document is a client information sheet for Prudential Guarantee and Assurance Inc. that collects personal details such as name, address, contact information, identification numbers, employment details, source of funds, and beneficiary names for individual clients. Upon completion, the client signs and dates the form which is then filled out by Prudential Guarantee with the client's assured code and intermediary.

    Original Title

    KYC-Form-Individual-Clien

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    This 3 sentence summary provides the key details about the client information sheet document: The document is a client information sheet for Prudential Guarantee and Assurance Inc. that collects personal details such as name, address, contact information, identification numbers, employment details, source of funds, and beneficiary names for individual clients. Upon completion, the client signs and dates the form which is then filled out by Prudential Guarantee with the client's assured code and intermediary.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    194 views1 page

    Prudential Guarantee and Assurance Inc.: Client Information Sheet - For Individual Client

    Uploaded by

    Ryan Redoble Delmo
    This 3 sentence summary provides the key details about the client information sheet document: The document is a client information sheet for Prudential Guarantee and Assurance Inc. that collects personal details such as name, address, contact information, identification numbers, employment details, source of funds, and beneficiary names for individual clients. Upon completion, the client signs and dates the form which is then filled out by Prudential Guarantee with the client's assured code and intermediary.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Prudential Guarantee and Assurance Inc.

    Coyiuto House 119 C. Palanca St. Telephone Number: 810-4916


    Legaspi Village, Makati City Website: www.prudentialguarantee.com
    CLIENT INFORMATION SHEET – For Individual Client*

    Complete Name (Last, First, Middle): ________________________________________________________________________


    Present Address: _______________________________________________________________________________________
    Permanent Address: _____________________________________________________________________________________
    Contact Numbers: ___________________________________ Nationality: _________________________________________
    Date of Birth: _______________________________________ Place of Birth: _______________________________________
    TIN: ____________________ SSS / GSIS No.:________________ ID No. & Issuer**_________________________________
    Nature of Work: _____________________________________ Name of Employer: ___________________________________
    Nature of Self-employment / Business: ______________________________________________________________________
    Source of Funds: _______________________________________________________________________________________
    Names of Beneficiaries, if applicable: ________________________________________________________________________
    ______________________________________________________________________________________________________
    Client’s Signature: _______________________________________ Date Signed: ____________________________________
    --------------------------------------------------------------------------------------------------------------------------------------------------------------------------
    This portion is to be filled up by Prudential Guarantee:

    Assured Code/s: ______________________________________________ Intermediary: _____________________________


    *As mandated by Philippine Anti-Money Laundering Act, as amended, and Its Implementing Rules and Regulations

    Important: Attach photocopy of valid ID**


    PGA-KYC-Form-01.03
    01-29-2014

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