Customer name: *

Address: *

Phone number: *

E-mail:

District: *

Commune: *

Address (house number, hamlet, village): *

ID card number: *

Release date: *

Front of ID card/CCCD: *

Back of ID card/CCCD: *

Front of the poor household book:

Back of the poor household book:

Front of land documents:

Back of land documents:

Front of related documents:

Back of related documents:

Unit name: *

Head Office Address: *

Representative: *

Position: *

Phone number: *

E-mail:

District: *

Commune: *

Installation address: *

Business license number: *

Business Registration Certificate or Establishment Decision: *

Lease agreement or power of attorney:

Front of the Land Documents:

Back of Real Estate Documents:

Front of related documents:

Back of related documents: