INFORMATION SHEET
REMITTERS DETAILS All fields are required
Remitters Name : Benedict Relationship to the Recipient : Friend Home Address :1255 manila Home Phone : n/a Corporate Name : n/a Corporate Address : n/a Corporate Phone : n/a Corporate Website : n/a YESPinoy Member No. : Nationality : Mobile No. : Occupation :
55261
Filipino 09272145124 n/a
Fax No. :
n/a kenshinxz16@y Email Address : ahoo.com
SMART MONEY CARDHOLD ERS DETAILS
Family Name : Robles Given Name : Lovewin Middle Name : Hemillan Name on SMART Money Card : Lovewin
Date of Birth : 1994-10-27 (yyyy-mm-dd) SMART Money 529967245221 Card Number : 4112 Valid Dates : 6/11-6/13 1655 malate Home Address : manila Home Phone : n/a Mobile No. : 09497020301 Organization or Company : n/a Occupation : n/a Company Address : n/a Company Phone : n/a Fax No. : n/a ruronixz1_kens E-mail hinxz1@yahoo. Company Address : com Website : n/a ID Number : 2011150303 ID Expiry Date : n/a Select ID Type Passport T. I. N. Drivers Company ID License
-- Student ID SSS / GSIS enrollment form ) Postal ID Voters ID Senior PRC ID Card Citizens Card
I hereby certify that all information stated above are correct and complete.
( plus student
Lovewin H. Robles Signature Over Printed Name Important : It is a requirement of the Central Bank and AntiMoney Laundering Legislation to obtain a completed YESPinoy Information Sheet from SMART Money Cardholders. Please submit this form via email, fax or mail together with the copy of your valid ID. You may call (02) 8972624 for inquiries. E-mail : HYPERLINK "mailto:support @yespinoy.com " support@yespi noy.com | Fax No. : (02) 8972623 | Address : 1009 Metropoliltan Ave., Makati
City 1205