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                            CLIENT INFORMATION SHEET

First Name: * ____________________________ Last Name: *_____________________________

Date of Birth: * ___________________________ M/F: ____________ TIN: __________________

Address: * _____________________________________________

Address Line 2: _________________________________________

City: * ________________________________________________

State/Province: * ________________________________________

Post/Zip Code: * ________________________________________

Email Address: * _______________________________________

Cellphone Number: * ___________________ Phone Number: * ______________________

Fax Number: * _______________________

Company Name: _________________________________________

Company Address: _______________________________________

Company Contact Numbers: _______________________________
5/F HPL Bldg.                                                                             Tel: (632)889-1111 to 16
# 60 Sen. Gil Puyat Ave.,                                                                 Fax: (632) 816-0983
Makati City, Philippines                                                        
                                                   LED MOTION BOARD
                                               EDSA CORNER SHAW BOULEVARD

Date of Booking:
Cellphone number:                                    Land line number:
Fax number:                                          Email Address:
Design from: (Please check)
Own design _____       Design from Greetings Website: _____

Type of Greeting            Date/s of Airing        Rate per Day         No. of Days   Total Amount
                                                    4,500.00 php + VAT

Motion Board Message (Please write the exact Motion Board message in block letters ):

Terms and Conditions:

    1. Client must have a log in data in the website.
    2. Submitted videos, pictures, and texts shall be subject to the approval of
    3. Files must be in high resolution (768x576 pixels) format and vertical form.
    4. Designs must be sent to at least two weeks before target date of airing.
    5. Payments must be made through bank deposits only.
    6. Contract, scanned I.D (SSS ID, Passport, Driver's License) and Deposit Slip must be sent to through
       email ( or fax (8160983) once design/material is approved.
    7. Greetings will be aired for 6.5 seconds per slot (from 6 am to 5 pm, every 6 minute cycle, 110 times a
    8. Date of airing shall be non-transferable.
    9. Contract cannot be rescinded.

By the execution of this instrument, the undersigned Client assumes all liability and responsibility for the content
of his/her posted message, and hereby agrees to hold and United Neon Advertising, Inc. and their
directors, officers and employees free and harmless from and against any and all liability for any and all
damages to any person caused by the posting of the Client’s message on the LED motion board of
or United Neon.

The Client hereby warrants the information contained in this instrument and acknowledges that
and United Neon have has relied in good faith to his /her representations herein.

                                       Printed Full Name and Signature of Client