Note: Please submit two (2) 1”x1” pictures Date: ________________

UNIT INFORMATION
Building: Unit Number: Area: Move-in Date:
Pacific Icon 1 308 26.11 SQ. M.
TENANT’S PERSONAL INFORMATION
Last Name First Name Middle Name
Macaraig Charlie Aranas
Home Address Billing Address
71 Apacible Street, Philamlife Village, Las Pinas City (same as home address)
Telephone Number Fax Number Mobile Number Email Address
09209507694 charles_macaraig@yahoo.com
Citizenship Date of Birth Place of Birth Civil Status Sex
Filipino Oct. 13, 1970 Batangas City □ Single □ male
□ Married □ female
□ Separated
□ Divorced
□ Widower
Occupation Company Name Office Address / Office Number
Claims Manager Primecars Insurance Agency Room 201, RA Building, Quezon Avenue,
Quezon City
Person to notify in case of emergency Contact Number Email Address
Marjorie Macaraig 09399363477 marj_g_macaraig
@yahoo.com
AUTHORIZED OCCUPANTS OF THE UNIT
Name Age / Sex Relation Remarks
Cara Amila Marie Macaraig 18/F Daughter
Janine Claudette Rama Salinas 17/F Friend
Renz Andrei Aquino Oredina 18/M Friend
/
/
I hereby confirm that all information stated herein is true and correct.

____________________________ ____________________________
Tenant’s Name and Signature Date

Note: All information stated herein shall be kept confidential by the Condominium Corp. and the Property Management
Office.