Strictly no erasures.

1228281434
G/F Unit EC-05B East Tower Philippine Stock Exchange Centre Exchange Road, Ortigas Center, Pasig City 1605, Philippines Tel No. (632)687-5071; Fax No. (632)687-3738

Individual Account
Last Name Address

CUSTOMER ACCOUNT INFORMATION FORM

First Name

Philstocks.ph

TM

Villavicencio Tierra Alta, Taal, Batangas villavicenciomjay@gmail.com 2/12/1992 Single

Jayson

Middle Name

Moreto

Email Address Birth Date

Telephone Number

N/A

Mobile Number Country Gender

09062819877 Philippines Male

Birth Place Nationality Username

Tierra Alta, Taal, Batangas Filipino

Civil Status TIN

jayson27

I confirm that the above information given is true and correct. Accord Capital Equities Corp. is hereby authorized to verify the same from whatever sources it may consider appropriate. Any misrepresentation made on the submitted documents is sufficient ground for legal action against me and the rejection of this application. Should this application be denied, Accord Capital Equities Corp. has no obligation on its part to furnish the reason for such rejection.

Jayson Moreto Villavicencio

Signature Over Printed Name
IMPORTANT REMINDERS: 1.) Please bring any identification cards: Primary ID (any one (1) of the ff:) Passport PRC SSS (new) Drivers License TIN (new) GSIS card (new) Secondary ID (any two (2) of the ff:) Senior Citizen Card Company ID Credit Card SSS/TIN (old) ATM Card Foreign Drivers License ACR (Alien Certificate Registration)

Date

2.) Payment modes available: Cash Check (please make it payable to Accord Capital)

For ACEC use only

Received and verified by

Do not write below this line

Salesman Approver

Signature Over Printed Name

Signature Over Printed Name

Processed by

Initial deposit verified by

Signature Over Printed Name

Authorized by

Signature Over Printed Name

Signature Over Printed Name

Date

2011 Philstocks.ph An online trading division of Accord Capital Equities Corp. All rights Reserved. Member: Philippine Stock Exchange

Strictly no erasures. Write application code here

G/F Unit EC-05B East Tower Philippine Stock Exchange Centre Exchange Road, Ortigas Center, Pasig City 1605, Philippines Tel No. (632)687-5071; Fax No. (632)687-3738

Individual Account
Residential Address Occupation Business Address Account Name

CUSTOMER ACCOUNT INFORMATION FORM

Philstocks.ph

TM

Employer

Business Telephone Number

Bank and Branch

Bank Account Number

Identification documents (any of the following with picture): Drivers License Passport TIN ID Others

Settlement Instructions
Registry of Certificates: In Street In Clients Name Note: All securities purchased by non-Metro Manila clients shall be registered in street name. Account Type: Investment Objective: Annual Income Cash Speculation Assets Yes No Discretionary Long-term Margin Growth Networth Preservation of Capital

Are you an officer of a public listed company? Do you have an account with another broker? If yes, state the name of the broker.

If yes, state the name of the company and your position. Yes No

For ACEC use only

Commission Rate: 0.25%

Do not write below this line

Received and verified by:

Salesman Approver:

Signature Over Printed Name

Signature Over Printed Name

Processed by:

Initial deposit verified by:

Signature Over Printed Name

Authorized by:

Signature Over Printed Name

Signature Over Printed Name

Date

2011 Philstocks.ph An online trading division of Accord Capital Equities Corp. All rights Reserved. Member: Philippine Stock Exchange

Accord Capital Equities Corporation

Philstocks.ph
Last Name

Write application code here

TM

Individual Account Jayson

First Name

Villavicencio Tierra Alta, Taal, Batangas

Address

Moreto
Middle Name

N/A
Telephone Number

09062819877
Mobile Number TIN Specimen Signature for Applicant (please sign twice)

1.) 1.)

2.) 2.)
Verified by:

Signature Over Printed Name

Date

2011 Philstocks.ph An online trading division of Accord Capital Equities Corp. All rights Reserved. Member: Philippine Stock Exchange

Certi cates will not be issued in your name unless your specimen signature card is on le with the transfer agent of the company. For your own protection and guidance of your transfer agents, please ll out this card and return to Accord Capital Equities Corp., g/f EC-058 Philippine Stock Exchange Center, Exchange Road, Ortigas Center, Pasig City.

Accord Capital Equities Corporation

Philstocks.ph
Last Name

Write application code here

TM

Individual Account Jayson

First Name

Villavicencio Tierra Alta, Taal, Batangas

Address

Moreto
Middle Name

N/A
Telephone Number

09062819877
Mobile Number TIN Specimen Signature for Applicant (please sign twice)

1.) 1.)

2.) 2.)
Verified by:

Signature Over Printed Name

Date

2011 Philstocks.ph An online trading division of Accord Capital Equities Corp. All rights Reserved. Member: Philippine Stock Exchange

Certi cates will not be issued in your name unless your specimen signature card is on le with the transfer agent of the company. For your own protection and guidance of your transfer agents, please ll out this card and return to Accord Capital Equities Corp., g/f EC-058 Philippine Stock Exchange Center, Exchange Road, Ortigas Center, Pasig City.