I Certify That All the Data Are True

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					                                                                          BIO–DATA                                                        Planters DB Properties, Inc.
                                                                          PERSONAL DATA
FAMILY                               FIRST                   MIDDLE                            NICKNAME
NAME                                 NAME                    NAME
RESIDENCE                                                    OWN            BIRTHDAY           AGE                   RES.TEL NO.
ADDRESS                                                      RENT                                                                                                PHOTO
PROFESSION                           T.I.N. No.                             HEIGHT                                   WEIGHT
CIVIL                    Single      Widowed                 CITIZENSHIP                       BIRTHPLACE            RELIGION
STATUS                   Married     Separated
NAME OF                              MO./YR                  NO. OF SALES                                            LICENSE NO.
REALTY                               FOUNDED                 FORCE
OFF. BUS                                                     POSITION                          NO.OF YRS AS BROKER                                OFC. TEL NO.
ADDRESS
                                                                                 SPOUSE
FAMILY                               FIRST                                  MIDDLE                                   NICKNAME                     BIRTHDAY
NAME                                 NAME                                   NAME
EMPLOYER/                                                                   OFC./BUS                                 OFFICE
BUSINESS                                                                    ADDRESS                                  TEL NO.
                                                                          FAMILY BACKGROUND
                                         PARENTS/BROTHERS/SISTERS                                                                             CHILDREN
NAME                      AGE                RELATION                       COMPANY/ BUSINESS                                   NAME                   AGE           SCH./OFC




                                                                              EDUCATION
LEVEL                                         SCHOOL                               ADDRESS                                      YEAR                           DEGREE
ELEM
HIGH SCHOOL
COLLEGE
POST GRADUATE
                                                                          SEMINARS ATTENDED




                                                                          EMPLOYMENT RECORD
               COMPANY                       POSITION              YEAR                   COMPANY                                      POSITION                           YEAR




                                                                             MEMBERSHIP
            ORGANIZATION                     POSITION              YEAR                 ORGANIZATION                                   POSITION                           YEAR




                                                                    TRACK RECORD IN REAL ESTATE
             Properties Sold         # of Units Sold                  Properties Sold             # of Units Sold                            Specialization
                                                                                                                     Lots                         Townhouse
                                                                                                                     House & Lot                  Brokerage
                                                                                                                     Condo                        Rowhhouse
                                                                              REFERENCES
                 NAME                                  COMPANY                            POSITION                                 RES. ADDRESS                          TEL NO.




                                                                 OWNERSHIP OF REAL ESTATE PROPERTY




Hobbies         NO CRIMINAL CASE                                                I hereby certify that all data stated herein                             VEHICLE OWNED
                NO CIVIL CASE                                                              are true and correct
                CHARGED WITH CRIMINAL CASE
                CHARGE WITH CIVIL CASE                                                                                                            RECRUITED BY:
SICKNESS/                                                                                     SIGNATURE
AILMENT                                                                                                                                              WALK-IN       AD RESPONDENT

				
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