Remittance Form 2017
Please fill up for your collection report
Agent/Broker *
Transaction *
Client's source *
Client's category *
Client's Name *
Your answer
Client's Contact Number *
Mobile, landline, etc. please follow our format i.e. 091X-234-5678 / 456-8797
Your answer
Client's Email Address
Your answer
Property Name *
Condominium building, office building, house, etc.
Your answer
Unit Number *
Your answer
Property Code
CRD/CSD (If none, please indicate owner and contact number)
Your answer
Amount Collected *
In PHP, actual collected amount
Your answer
Collection type *
Collection % *
Percentage of collection (i.e. 50%, 100% or 1/12, 1/6)
Your answer
Contract Amount *
In PHP, amount reflected on the Contract of Lease or Deed of Sale
Your answer
Collection Sharing *
Please indicated Broker/Agent's name in remarks if there is
Contract Starts (Rent) / Contract Date (Sale) *
MM
/
DD
/
YYYY
Contract Ends (Rent) *
If SALE, just input same date as above
MM
/
DD
/
YYYY
Requirement/s submitted *
Notes/remarks
Your answer
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