BRANCH NAME UEMI LINGAYEN - YAMAHA

TOTAL 2
DATE OF BUYER'S NAME SOURCE No.
NO.
APPLICATION ( Surname, First Name, Middle Name ) DR / VOUCHER/OR/

1 May 10, 2017 Boniol, Regie Geminiano 6564

2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
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23
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25
26
27
28
29
30
31
32
33
34
36
37
38
39
40
41
42
43
44
45
 No. of
TYPE OF MEMBERSHIP BRAND & MODEL
FSEC
(Premium / E-Replacement / ENGINE NUMBER
Replacement / Renewal/PLUS ) PURCHASED white yellow

REPLACEMENT MIO I 125 BB32 E3R2E-1013114 10 2

2
2
2
2
2
2
2
2
2
2
2
 G-CARD APPLICATION MONITORING
(Email to: gcard@guanzongroup.com.ph OR AT manny.deleon1572@G

FSEC Expiration Date No. of GIFT COUPON MODE OF

(for E-Replacement only) PAYMENT

SURRENDER
CASH
APPLICATION MONITORING
o: gcard@guanzongroup.com.ph OR AT manny.deleon1572@Gmail.com)

NAME TO DISPLAY

ALL CAPS LOCK : ( First Name, M I, Surname )

LIZA C. PALABINO
TORING
y.deleon1572@Gmail.com)

CARD NUMBER CARD VALIDITY

 CARD STATUS DATE RECEIVED
REMARKS
GC SYSTEM: VERIFIED / PRINTED / ENCODED / ACTIVATED ( Branch G-CARD Monitoring )
 BATCH No. RELEASED GCARD POINTS Replacement
PREVIOUS CARD NUMBER
( CARD PRINTING ) TF NO. GCTF DATE (RENEWAL) DEFFECTIVE

0921600019809
Replacement

LOST CARD
RCVD DATE
/