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    SEIS Form For Test Environment

    Uploaded by

    Princess Salvador
    This document is a submitting entity information sheet for an organization to access a credit information system for testing purposes. It collects information such as the submitting entity name, type, address, primary and secondary contacts, head of agency, and authorized users who will have access to submit data and view error reports through batch or web channels. The entity certifies that the information provided is true and complete.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd

    SEIS Form For Test Environment

    Uploaded by

    Princess Salvador
    164 views3 pages
    This document is a submitting entity information sheet for an organization to access a credit information system for testing purposes. It collects information such as the submitting entity name, type, address, primary and secondary contacts, head of agency, and authorized users who will have access to submit data and view error reports through batch or web channels. The entity certifies that the information provided is true and complete.

    Original Description:

    in compliance with R.A 9510

    Original Title

    SEIS Form for Test Environment

    Copyright

    © © All Rights Reserved

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    This document is a submitting entity information sheet for an organization to access a credit information system for testing purposes. It collects information such as the submitting entity name, type, address, primary and secondary contacts, head of agency, and authorized users who will have access to submit data and view error reports through batch or web channels. The entity certifies that the information provided is true and complete.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    164 views3 pages

    SEIS Form For Test Environment

    Uploaded by

    Princess Salvador
    This document is a submitting entity information sheet for an organization to access a credit information system for testing purposes. It collects information such as the submitting entity name, type, address, primary and secondary contacts, head of agency, and authorized users who will have access to submit data and view error reports through batch or web channels. The entity certifies that the information provided is true and complete.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    You are on page 1of 3

    FOR TESTING PURPOSES ONLY CIC Control Number

    TIN Number
    Credit Information Corporation
    Submitting Entity Information Sheet
    Company Registration Number

    Submitting Entity Name

    Submitting Entity Type

    Commercial/Universal Bank Rural Bank Thrift Bank Micro-Finance


    Cooperative Utility & Services
    Utility Trust
    Trust Entity
    Entity Insurance / MBA
    (Telco, Cable, etc.)
    Pawnshop Leasing & Financing,
    Credit Card Government Lending Institution Pawnshop Leasing/Financing
    Lending Company Leasing Company
    Company
    Investment House Other Government Institution Private Lending
    Financing Institution
    Company Others____________

    Address

    Primary Contact Person

    Last Name First Name Middle Name

    Position Contact Number E-mail

    Secondary Contact Person

    Last Name First Name Middle Name

    Position Contact Number E-mail

    Head of Agency/Office (President/Chairman/CEO/General Manager, or its equivalent)

    Last Name First Name Middle Name

    Designation (Please specify) Contact Number(s) E-mail

    Authorized Representative
    I hereby certify that the names of the individuals indicated
    in this Information Sheet are the duly authorized
    employees/personnel of the Submitting Entity indicated above
    who will submit data and access the error report folders of the
    Credit Information System.
    __________________________________________
    I declare under the penalty of perjury that the information Signature Above Printed Name
    and facts stated herein are true, correct and complete.
    I hereby certify that the names of the individuals indicated
    in this Information Sheet are the duly authorized
    employees/personnel of the Submitting Entity indicated above
    who will submit data and access the error report folders of the
    Credit Information System.

    I declare under the penalty of perjury that the information


    and facts stated herein are true, correct and complete.
    Date : _______________

    FOR CIC USE ONLY

    Recommending Approval Approved

    __________________________________________ __________________________________________
    Signature Above Printed Name Signature Above Printed Name
    Date : _______________ Date : ____________________

    Page 1 of 2
    Operators

    Access Role
    Last Name First Name Middle Name Designation Contact Number Email Branch Code
    Batch Web

    Authorized Representative

    ___________________________________
    Signature Above Printed Name

    * Access Roles in CIS Test


    Batch Access Role given to those with submission & enquiry functions using batch (ftp) channel
    Web Access Role given to those with enquiry (only) function using the web channel (most users fit in this role)

    NOTE: Test (UAT) accounts are limited to 5 users only.


    Individual Email must be provided. Communal or Group Email is not allowed

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