SELLER AFFILIATION FORM

Place N/A if Not Applicable

1. Personal Profile

Name of Broker

2. Educational Background

3. Selling Experience

4. Fields of Specialization

5. Character References

I hereby commit to abide by, and/or achieve the following as the basis of my accreditation:

• Abide by the PPPVI Rules and Regulations and Code of Ethics governing PPPVI accredited agents

• Attain the required sales production set by the PPPVI management;

• Actively participate in all PPPVI sales and marketing activities.

I understand that failure to attain any of the aforementioned conditions and any false statements /information herein may be grounds for PPPVI to disapprove my application for accreditation.

I have read this form, understood its contents and consent to the processing of my personal data. I understand that my consent does not preclude the existence of other criteria for lawful processing of personal data, and does not waive any of my rights under the Data Privacy Act of 2012 and other applicable laws.

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