Form No. G001.3 Signature Card Account Information Form

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S IGNATURE C ARD / A CCOUNT INFORMATION F ORM

Page ____of____ New Account Updating


Account Number
Date
MM DD YYYY
Account Name:

Client Name: (Last Name, First Name, Middle Name)


Product Name: _______________________________________

Please sign three times using black ink. Product Type:


SA CA TD Others ___________________

Type of Currency:
Others ____________________________
FRONT

PHP USD

Account Type Type of Signatory


(for Business Account)
Individual * Business Any One All
Joint : OR AND Any Two
* For Individual Accounts you are eligible to enroll your account
in Internet Banking and Mobile Banking.
Customer Agreement
I hereby agree to the use of this Signature Card in
accordance with the terms and conditions governing the
product, facility and/or services I availed and will avail in
the future. I acknowledge that such terms and conditions
may be amended from time to time.
G001.3 July'19

Statement Disposition
Electronic Mail/Softcopy to preferred Pick-up (on Demand) at the
Email address _____________________ Branch

Purpose With Correspondence?


(Please specify reason)
Yes No
Customer Instruction Upon Maturity of Time Deposit
Automatic Renewal of Principal + Interest Full Redemption on Maturity Date

Automatic Renewal of Principal. Interest will be Others___________________________________


credited to Affiliate Account
Affiliate Account where proceeds will be credited:
BACK

For Bank Use Only


SSS /
ID/s Philsys GSIS Others ______________________________
SSS UMID
presented: Driver's
Passport
License
ID Expiry Date:
ID Number : _________________________________ MM DD YYYY
Signature Taken by: Signature Verified by: Processed by:

____________________________ ____________________________ ____________________________


Signature Over Printed Name / Date Signature Over Printed Name / Date Signature Over Printed Name / Date
Verified Against CWS / Documents Verified Against Approved by:
Dowjones by: Original and BBS / BBI by:

____________________________ ____________________________ ____________________________ ____________________________


Signature Over Printed Name / Date Signature Over Printed Name / Date Signature Over Printed Name / Date Signature Over Printed Name / Date

Revised per OPP No. 05-0034.1/2019 dated July 31, 2019

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