PRESTIGE HOMES & REALTY DEVELOPMENT CORPORATION

KEAN Bldg. FS Dizon Road, El Rio Vista Village, Bacaca Davao City
Tel. No.: 241 2683; Telefax: 241 0127

PURCHASERS INFORMATION SHEET

Page 1 of 3

Date:
MM DD YY
Instructions:
1. Type print all entries in Block or CAPITAL LETTERS
2. Write N/A if the entries are not applicable.

1. PROPERTY DETAILS

NAME OF PROJECT
Location of Project

City / Municipal

Province Country Zip Code

House Model Block No. Lot No. Lot Area

2. APPLICANT INFORMATION
Name

Last Name First Name Middle Name

MM DD YY

Extension Citizenship Birth Date Age Civil Status Religion

Government Issued I.D.

- - - - - - - - -
S.S.S. Number PAG-IBIG(HDMF) Number PHILHEALTH Number T.I.N. Number

Others
Place of Birth

Street Block Lot City / Municipal

Province Country Zip Code

Home Address / Present Address

Street Block Lot City / Municipal

Province Country Zip Code

Contact Details

Mobile Number 1 Mobile Number 2 Home Telephone Number Office Telephone Number

Email Address

Facebook Account (Ex.: fb.com/prestigehomesrealtyofficialpage or full name from your facebook account)
3. APPLICANT BUSINESS / EMPLOYMENT INFORMATION
Name

Firm

Employers Email Address

 PRESTIGE HOMES & REALTY DEVELOPMENT CORPORATION
KEAN Bldg. FS Dizon Road, El Rio Vista Village, Bacaca Davao City
Tel. No.: 241 2683; Telefax: 241 0127

PURCHASERS INFORMATION SHEET

Page 2 of 3

Nature of Business Position Department

Earning per month

How long?
Office Address

Street Block Lot City / Municipal

Province Country Zip Code

Office Contact Details

Mobile Number 1 Mobile Number 2 Office Telephone Number 1 Office Telephone Number 2

Email Address
4. SPOUSE INFORMATION
Name

Last Name First Name Middle Name

MM DD YY

Extension Citizenship Birth Date Age Civil Status Religion

Government Issued I.D.

- - - - - - - - -
S.S.S. Number PAG-IBIG(HDMF) Number PHILHEALTH Number T.I.N. Number

Others
Place of Birth

Street Block Lot City / Municipal

Province Country Zip Code

Home Address / Present Address

Street Block Lot City / Municipal

Province Country Zip Code

Contact Details

Mobile Number 1 Mobile Number 2 Home Telephone Number Office Telephone Number

Email Address

Facebook Account (Ex.: fb.com/prestigehomesrealtyofficialpage or full name from your facebook account)
5. SPOUSE BUSINESS / EMPLOYMENT INFORMATION
Name

Firm
 PRESTIGE HOMES & REALTY DEVELOPMENT CORPORATION
KEAN Bldg. FS Dizon Road, El Rio Vista Village, Bacaca Davao City
Tel. No.: 241 2683; Telefax: 241 0127

PURCHASERS INFORMATION SHEET

Page 3 of 3

Employers Email Address

Nature of Business Position Department

Earning per month

How long?
Office Address

Street Block Lot City / Municipal

Province Country Zip Code

Office Contact Details

Mobile Number 1 Mobile Number 2 Office Telephone Number 1 Office Telephone Number 2

Email Address

6. OTHER INCOME

REAL PROPERTY OWNED

BANK REFERENCES
7. REFERRAL INFORMATION
PERSON WHO REFERRED YOU TO THE COMPANY
Sales Director

Last Name First Name Middle Name

Unit Manager

Last Name First Name Middle Name

Sales Executive

Last Name First Name Middle Name

MM DD YY

- - -
Date Paid A.R. # Amount Paid T.I.N

I/We affirm that each of the answers given to the foregoing questions are true and correct.

APPLICANT: With my Marital Consent:

(Signature above Printed Name) (Signature above Printed Name)