Customer Account Information Form: R R R R
Customer Account Information Form: R R R R
Customer Account Information Form: R R R R
2401-B East Tower, Philippine Stock Exchange Centre 2401-B East Tower, Philippine Stock Exchange Centre Exchange Road, Ortigas Center, Pasig City, 1605 Philippines Exchange Road, Ortigas Center, Pasig City, 1605 Philippines Customer Hotline +632 651 5888 Fax +632 636 3512 Customer ServiceService Hotline (632) 6-333-777 Fax No.No. (632) 6-363-512 Email Address: helpdesk@colfinancial.com Email Address: helpdesk@citiseconline.com
INDIVIDUAL
PERSONAL INFORMATION
Last Name First Name Middle Name Gender Date of Birth (Month/Day/Year) Place of Birth (Town/City/Province) Citizenship Tel. No. / Mobile No. Facsimile No. Email Address Residential Address
JOINT OR
OTHERS
Please fill up clearly in BLOCK LETTERS and affix signature(s). PRIMARY ACCOUNT HOLDER
Male
Female
Male
Female
Filipino
Other _______________
Filipino
Other _______________
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Single Married
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Separated Widowed
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Single Married
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Separated Widowed
ADDITIONAL INFORMATION
Employment Status TIN or SSS / GSIS No. Name of Employer / Business Office Tel. No. Office Address
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TIN
Employed Self-employed
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TIN
Employed Self-employed
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DISCLOSURES
Are you a corporate officer or director of a PSE-listed company? Are you an officer or employee of another Broker / Dealer? Other Brokers where you have an account.
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Yes
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No
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Yes
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No
Yes
No
Yes
No
If yes, specify company name and provide a consent letter from employer. ___________________________________________
If yes, specify company name and provide a consent letter from employer. ___________________________________________
1. 2.
1. 2.
r r r r r r r r
<500,000 <10 Million <500,000 <10 Million <500,000 Salary Retirement None
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<1 Million r <5 Million Over 10 Million <1 Million r <5 Million Over 10 Million <1 Million
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<1 Million r <5 Million Over 10 Million <1 Million r <5 Million Over 10 Million <1 Million
Over 1 Million
Over 1 Million
Limited
Good
Extensive
r Salary r Business r Investments r Retirement r Others _________________ r None r Limited r Good r Extensive
_______ _______ _______ _______ Capital Preservation Long-term Investment Growth Speculation
I/We confirm that all the information given in this CAIF are true and correct. COL is hereby authorized to verify the same from whatever sources it may consider appropriate. Any misrepresentation made on the submitted documents is sufficient ground for legal action against me/us and the rejection of this application. Should this application be denied, COL has no obligation on its part to furnish the reason for such rejection. Signature(s)
Date
Date
A. BASIC REQUIREMENTS: 1. Minimum cash/check deposit payable to COL Financial Group, Inc. for opening of the following accounts: Regular Trading Account - Php 25,000; and Easy Investment Program (EIP) Account - Php 5,000; 2. Photocopy of one (1) identity document issued by the Philippine Government e.g. passport, drivers license, SSS/GSIS ID, Professional Regulation Commission (PRC) ID, and Comelec Voters ID. (Please present original for verification); 3. Two (2) copies of Specimen Signature Cards; and 4. Online Securities Trading Agreement duly signed. B. ADDITIONAL REQUIREMENTS FOR THE FOLLOWING: 1. Without face-to-face opening of account - a latest copy of any of the following documents must be submitted: Public Utility Bill, Credit Card Statement or Bank Statement. 2 Resident Foreigners - include a photocopy of: a. Alien certificate of registration (ACR) issued by the Bureau of Immigration; OR b. A Certification to engage in business or working permit issued by the Department of Labor & Employment (DOLE). 3. Non-Resident Foreigners - include the following: a. Proof of Income certified by Employer; AND b. Identity Documents authenticated by Philippine Embassy or Consulate.
EIP
REGULAR
PCG
OTHERS _______________________
Salesman/Referred By:
Processed By:
Date Opened:
Approved By: