Client Profile Registration System

DATA ITEM / INFORMATION
Scanned Photo/ Mandatory
Please submit your photo or logo in JPEG Form.
Nature of Business/ Mandatory
Business Name / Mandatory
Accepts the following special characters [. / ' - & ( )]
First Name / Mandatory
Onlyfor clients with business entity "Individual" or "Sole Proprietorship"
Middle Name / Mandatory
Only for clients with business entity "Individual" or "Sole Proprietorship"
Last Name / Mandatory
Only for clients with business entity "Individual" or "Sole Proprietorship"
Country of Citizenship/ Mandatory
Address
Address / Mandatory
Accepts the following special characters [. / , -]
City / Mandatory
Accepts the following special characters [. / , -]
Zip Code / Mandatory
Country / Mandatory
Contact Information
Phone / Mandatory
Minimum must be 7 characters
Alternate Phone / Optional
Minimum must be 7 characters
Mobile Phone/ Optional
Minimum must be 7 characters
Fax / Optional
Minimum must be 10 characters
Email/ Mandatory
URL/Website / Optional
Warehouse / Transit Shed Code/ Optional
TIN / Mandatory
Social Security Number/ Optional
Passport Number/ Optional
Driver's License / Optional
PRC ID No./ Optional
Primary VASP CCN No./ Mandatory / VA0000000051
Secondary VASP CCN No. / Optional
PEZA-BOI Registration Number (if applicable)/CARR Code /Optional
This field becomes mandatory when the business entity is set to "Company", "Corporation" or "Partnership".
SEC Registration Number/ Mandatory
This field becomes mandatory when the business entity is set to "Company", "Corporation" or "Partnership".
Amount of Authorized Capital Stock/ Mandatory
This field becomes mandatory when the business entity is set to "Company", "Corporation" or "Partnership".
Amount of Paid up Capital/Mandatory
This field becomes mandatory when the business entity is set to "Company", "Corporation" or "Partnership".
Related domestic & foreign companies
Accepts the following special characters [. / ' -]
Related company 1 / Optional
Related company 2 / Optional
Related company 3 / Optional
Primary Broker / Mandatory
TIN / Mandatory
Code / Mandatory
Secondary Broker / Optional
TIN / Mandatory
Code / Mandatory
Plant Addresses/ Mandatory to indicate at least one (1) Plant Address
Address/ Mandatory
Accepts the following special characters [. / ' -]
City / Mandatory
Accepts the following special characters [. / ' -]
Zip Code / Mandatory
Country / Mandatory
Major Stockholders/ Mandatoryto indicate at least one (1) Major Stockholder
This field becomes mandatory when the business entity is set to "Company", "Corporation" or "Partnership"
Please put the name of a member of the Board of Directors.
First Name / Mandatory
Middle Name / Mandatory
Last Name / Mandatory
Country of Citizenship/ Mandatory
TIN / Mandatory
Photo / Mandatory
Please submit in JPEG Form.
Signature / Mandatory
Please submit in JPEG Form.
Address
Address / Mandatory
Accepts the following special characters [. / , -]
City / Mandatory
Accepts the following special characters [. / , -]
Zip Code/ Mandatory
Country/ Mandatory
Phone / Mandatory
Minimum must be 7 characters
Alternate Phone / Optional
Minimum must be 7 characters
Mobile / Optional
Minimum must be 7 characters
Fax / Optional
Minimum must be 10 characters
Email / Mandatory
Principal Officers/ Mandatory to indicate at least one (1) Principal Officer
First Name / Mandatory
Middle Name / Mandatory
Last Name / Mandatory
Position / Mandatory
TIN / Mandatory
Photo / Mandatory
Please submit in JPEG Form.
Signature / Mandatory
Please submit in JPEG Form.
Address
Address / Mandatory
Accepts the following special characters [. / , -]
City / Mandatory
Accepts the following special characters [. / , -]
Zip Code / Mandatory
Country / Mandatory
Phone / Mandatory
Minimum must be 7 characters
Alternate Phone / Optional
Minimum must be 7 characters
Mobile / Optional
Minimum must be 7 characters
Fax / Optional
Minimum must be 10 characters
Email / Mandatory
Responsible Officers/ Mandatoryto indicate at least one (1) Responsible Officer
First Name / Mandatory
Middle Name / Mandatory
Last Name/ Mandatory
Position/ Mandatory
TIN / Mandatory
Area of Responsibility / Mandatory
Photo / Mandatory
Please submit in JPEG Form.
Signature / Mandatory
Please submit in JPEG Form.
Address
Address / Mandatory
Accepts the following special characters [. / , -]
City / Mandatory
Accepts the following special characters [. / , -]
Zip Code / Mandatory
Country / Mandatory
Phone / Mandatory
Minimum must be 7 characters
Alternate Phone / Optional
Minimum must be 7 characters
Mobile / Optional
Minimum must be 7 characters
Fax / Optional
Minimum must be 10 characters
Email/ Mandatory
Major Suppliers/ Mandatory to indicate at least one (1) Major Supplier
TIN / Mandatory
Name / Mandatory
Address
Address / Mandatory
Accepts the following special characters [. / , -]
City / Mandatory
Accepts the following special characters [. / , -]
Zip Code / Mandatory
Country / Mandatory
Phone / Mandatory
Minimum must be 7 characters
Alternate Phone / Optional
Minimum must be 7 characters
Mobile / Optional
Minimum must be 7 characters
Fax / Optional
Minimum must be 10 characters
Email/ Mandatory

Kindly send your duly accomplished form via email at . Thank you.

E-KONEK HELPDESK HOTLINE NUMBERS: 386-3942 to 45 / 386-3384 to 86 / 386-2605 / 1-800-108EKONEK

This is to certify that all information in this page are true and correct.

Approved for CPRS registration by: ______Page - 1 / 5

Authorized Company OfficerCPRS Importer Form