STARBRIGHT OFFICE DEPOT, INC.

V. MAPA STREET, BRGY.,12-B, DAVAO CITY

VAT REG. TIN: 005-978-639-002 CREDIT APPLICATION FORM
Tel. Nos. (082) 826 9042 Telefax No. (082)221-1798 Application Type: New Update

Instructions: Kindly, fill in every . Please do not skip any details. All items are necessary. If item is not applicable, please indicate NA. Thank you!
Note: This form can be electronically filled using Microsoft Excel.

A. GENERAL INFORMATION
A1. Business Name A4. Type of Organization
Sole Proprietorship NGO

A2. Business Address

Gov 't Agency Corporation

A3. Contact Information Others :

Telephone No. Mobile No. Fax No. E-mail Address TIN :

1 DTI Reg. No. :

2 Reg. Date :

3 SEC Reg. No. :

Registered Owner : Reg. Date :

Residence Address :

B. FACILITIES
B1. Real Estate
TCT No. Location Type Encumbrances
1

3
B2. Vehicles
Model/Year Particulars Market Value Registered Owner
1

C. PRINCIPAL OFFICERS
Name Designation Phone Number/E-mail Address Signature
1

D. TRADE REFERENCES
Trade Name Address Contact Person/Contact No. Credit Term Credit Limit
1

STARBRIGHT OFFICE DEPOT INC_CAF 1 OF 3

 E. AFFILIATE COMPANIES
Business Name Business Address Contact No,
1

F. AUTHORIZED COMPANY PERSONNEL

F1. Purchasing In-Charge F2. Goods Receiving In-Charge
Name Signature Name Signature
1 1

2 2

3 3

As a/responsible officer/s of _____________________________________________, I/we certify that the above information is

true and correct to the best of my/our knowledge.
I/We also understand the following and shall abide by the Company’s regulations:
1 Notify STARBRIGHT OFFICT DEPOT, INC. of any changes in ownership of our company.
2 If granted credit, I/we agree to pay all invoices within the approved credit terms of invoice date.
3 My/Our account shall be automatically termed C.O.D. if invoices are paid beyond the approved terms.
4 My/Our company’s financial condition is satisfactory and I/we can meet all financial obligations.
5 There are no lawsuits or judgments against me/us at this present time.
6 If my/our company defaults on payments of any outstanding valid invoices, I/we agree to pay attorney and/or
collection expenses.

Signature above Printed Name Designation Date

Signature above Printed Name Designation Date

This section is to be completed by STARBRIGHT OFFICE DEPOT, INC. Management only.

Credit Limit : PhP

Amount in Words Amount in Figures
Credit Term : c 30 days c 60 Days c 90 Days Other remarks :

Investigated by : Approved by: Date Approved :

Requirements
1 Photocopy of two (2) Valid IDs
2 DTI Certificate/SEC Certificate (Corp)
3 Latest Financial Statement
Siganture above Printed Name 4 Certificate of Registration

u For Disapproved Application 5 Current Mayor’s Permit

Reason: 6 Signage of the establishment, if applicable

STARBRIGHT OFFICE DEPOT INC_CAF 2 OF 3

 STARBRIGHT OFFICE DEPOT, INC.
V. MAPA STREET, BRGY.,12-B, DAVAO CITY
VAT REG. TIN: 005-978-639-002
Tel. Nos. (082) 826 9042 Telefax No. (082)221-1798
BANK CONFIRMATION (CUSTOMER CREDIT APPLICATION)

A1. Business Name

A2. Business Address

1. BANK REFERENCES
Bank 1 Bank 2 Bank 3
Bank Name

Branch Address

Contact Person

Contact Number/s

Account Name

Account Number

Account Type
Authorized Signatories
Name Signature Name Signature Name Signature
1

2. AUTHORITY FOR INVESTIGATION

To whom it may concern: Date :
Please allow STARBRIGHT OFFICE DEPOT, INC. to conduct an inquiry on our account with you.

I am waiving my right under RA 1405 “AN ACT PROHIBITING DISCLOSURE OF OR INQUIRY INTO, DEPOSITS WITH ANY
BANKING INSTITUTION AND PROVIDING PENALTY THEREFOR” or also known as The Bank Secrecy Law.

This authorization is issued in connection with our credit line application. Kindly, extend unto them all the necessary accom modation.

Thank you very much for granting this request.

(1) (2) (3)

Signature above Printed Name Signature above Printed Name Signature above Printed Name

This section is to be completed by BANK AUTHORIZED REPRESENTATIVE only

Bank Bank 1 Bank 2 Bank 3

CI Date
Type of Account
Date Opened
ADB (MTD)
History of Returned
Check, if any.

Remarks

Verified by

STARBRIGHT OFFICE DEPOT INC_CAF 3 OF 3