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Bankard

Disclosed Bankard Business Interview Form

Email * FV Name * Date of Ocular Visit * Time of Ocular Visit * Person Interviewed / Relationship with the subject * Subject's Name * Business Name * Trade Name * Former Business Name (if applicable) * Business Contact Details * Business Registered Owner / Top Management * Organization *

Corporation Partnership Sole Proprietorship None

Business Registration *

SEC DTI CITY PERMIT NO PERMIT

Nature of Business *

Manufacturing: Producing goods or products Retail: Selling goods directly to consumers Service: Providing services rather than tangible goods Trading: Buying and selling goods Technology: Developing and offering technological solutions Other

Main Line of Business * Major Products / Services * Subject's Position *

Owner President Chairman Vice-President Director Partner

%Ownership * Date Established and Years of Operation * Operating Days and Hours * Total No. Employees * Regular Employees * Contractual Employees * Gross Annual / Monthly Income * Business History * Major Customers * Major Suppliers * Business Succession Plan * Business Address * Business Former Address (if applicable) * Office Lot and Floor Area * Premises *

Owned Leased Used free Rented No Information

Premises Monthly Rental * Subject Business Employee Informant * Neighbor Informants Statement * Barangay Informants Statement * Branches / Affiliates (Address / No. of years operating / Renting or Owned) * Company Vehicles Owned * Subject's Assets * Fixed Assets *

Land Building Machineries Equipment Other

Furniture / Equipment / Fixtures *

Tables Computers Fax Machine Filling Cabinet Aircon Calculator Xerox Machine Typewriter

Average Gross Income Receivables Inventory (Financial) Fixed Assets (Value) Capital Average Net Income Liabilities Last Year's Sales * Financial Info obtained from *

Financial Statement Estimate

Financial Info provided by * Subject other business or source of income * Business Condition * Business Activity *

Brisk Slow Moderate

Product/Service *

Salable Slow

Signboard *

With Without

Location *

Good Poor

Inventory *

High Adequate Low

Area Classification *

Residential Commercial Industrial

CI Result *

Verified - Ok Verified - Adverse Not Verified Non Existent

Informant 1: (name/address/statement) * Informant 2: (name/address/statement) * Informant 3: (name/address/statement) * Other Info / Remarks *

Selfie with the Main Informant / Person Interviewed *

Picture of Structure (Left Side, Front, Right Side) *

Street View (Left, Front, Right) *

Picture of Barangay Hall *

Selfie at Barangay Hall *

Picture of Business Activity *

Product / Inventory *

Business Permits *

Others *

Section

ANTI-SUHOL REPORT

Report within 24 hours if you have experienced any form of bribery in kind or in cash while you were conducting verification.

Did you experience any type of bribery? (Material / Food / Money / Favors) Report the incident and any unlawful activities encountered. *

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