LESSOR INFORMATION SHEET

LESSOR NAME
(Property Owner)
CONTACT NO.

CONTACT PERSON
(Lessor's representative, if there is
Tax Identification
any) Number (TIN)

PAYEE NAME EMAIL ADDRESS

(Name to appear in the cheque or
(Email to receive payment
bank account name)
availability notification)

RESIDENCE ADDRESS
(Address where cheque should be VAT REGISTERED NO.
delivered) (Pls. provide sample Official
Receipt/OR)

To conveniently receive our payment, please provide your bank account details below. We will transfer our payment to this account.

BANK NAME
(Preferrably Commercial Bank)
BRANCH ADDRESS

ACCOUNT NAME ACCOUNT NUMBER

(This should be the same as payee
(Pls. ensure to provide correct
name indicated above)
account no.)

I hereby certify that the above information given are true and correct.

Printed Name over Signature / Date

(Lessor's Conformity)

To be filled out by PHILTOWER/ CONTRACTOR

SITE DATA

SEARCH RING

SITE NAME

SITE ID

SITE ADDRESS

RANK

SAQ REPRESENTATIVE

CONTACT NO.