CUSTOMER INFORMATION SHEET

FOR INDIVIDUAL CUSTOMER

CUSTOMER NO.: ______________________________ DATE CREATED/UPDATED (mm/dd/yyyy): _________________________

PERSONAL INFORMATION
Full Name (First Name, Middle Name, Last Name)

Date of Birth (mm/dd/yyyy) Nationality Citizenship

Sex Place of Birth Civil Status

PHOTO
Mother’s Maiden Name (First Name, Middle Name, Last Name) No. of Children

Present Address (No./Street, Subd.,Brgy./Dist./Municipality/City,Province) ZIP Code

Permanent Address (No./Street, Subd.,Brgy./Dist./Municipality/City,Province) ZIP Code E-mail Address

Residential Phone Number (Area code + Tel. no) (optional) Primary Mobile Number Secondary Mobile Number (optional) Tertiary Mobile Number (optional)

SPOUSE INFORMATION
Name of Spouse (First Name, Middle Name, Last Name) Date of Birth (mm/dd/yyyy) Profession

FINANCIAL INFORMATION
Occupation
Employed OFW/Overseas Filipino Farmer/Fisher Unemployed Lawyers/Notary/Independent Legal Professional/Accountant
Self-employed Retired Student/Minor Housewife Government Official

Tax Identification Number (TIN) - - - 0 0 0

Source of Wealth (1-Primary, 2-Secondary, 3-Other Source)

Salary/Honoraria Other Remittance Grant/Scholarship/Awards/Prizes/Benefits Fees and Charges

Interest/Commission Donations/Inheritance Royalties/Commission Taxes and Licenses

Business Allowance Sale of Assets Others - with documents

Pension Professional Fees - Others Loans Others - without documents

Regular Remittance Professional Fees - Lawyers/Notary/Independent Government Appropriations

Monthly Gross Income/Pension/Allowance
Php 30,000.00 and below Php 30,000.01-50,000.00 Php 50,000.01-100,000.00 Php 100,000.01-500,000.00 Over Php 500,000.00
Annual Gross Income/Pension/Allowance
Php 360,000.00 and below Php 360,000.01-600,000.00 Php 600,000.01-1,200,000.00 Php 1,200,000.01-6,000,000.00 Over Php 6,000,000.00
EMPLOYMENT INFORMATION
Employer’s Name Employer’s Address (No./Street, Subd.,Brgy./Dist./Municipality/City,Province)

Job Title Employment Date (mm/dd/yyyy) Phone/Fax Number

Nature of Business/Economic Activity

1700 - Private Household with Employed Persons G4547 - Wholesale and Retail Trade, Repair of Motor T9798 - Activities of Private Households as Employers and Undifferentiated
1800 - Extra-territorial Organizations and Bodies Vehicles and Motorcycles Goods and Services and Producing Activities of Households for own
1204 - Jewelry and Precious Stones Dealer H4953 - Transportation and Storage use (e.g., Activities of Households as Employers of Domestic Personnel
1005 - Foreign Exchange Dealer/Money Changer/ I5556 - Accommodation and Food Service Activities such as Maids, Cooks, Waiters, Valets, etc.)
Remittance Agent J5863 - Information and Communication U9900 - Activities of Extraterritorial Organizations, and Bodies (e.g., Activities of
A0103 - Agriculture, Forestry, and Fishing K6466 - Financial and Insurance Activities International Organizations, such as, United Nations, ASEAN, etc.)
B0509 - Mining and Quarrying L800 - Real Estate Activities V0000 - Others
C1033 - Manufacturing M6975 - Professional, Scientific, and Technical Activities V0001 - Others - Student/Minor/Retiree/Pensioner
D3500 - Electricity, Gas, Steam, and N7782 - Administrative and Support Service Activities V0002 - Others - Unemployed/Housewife
Air-conditioning Supply O8400 - Public Administrative and Defense; Compulsory 9200 - Gambling and Betting Activities
E3639 - Water Supply, Sewerage, Waste Social Security 9210 - OGOs and OGO Service Providers
Management and Remediation Activities P8500 - Education 9220 - Casinos
(e.g., Cleaning Up of Oil Spills) Q8688 - Human Health and Social Work Activities
F4143 - Construction (e.g., Construction of R9093 - Arts, Entertainment, and Recreation
Buildings, Railroad Infrastructures) S9496 - Other Service Activities (Activities of Membership
Organizations)

CIS - Individual | Page 1 of 3 Revised August 2021

 ADDITIONAL INFORMATION
List of Companies where Depositor is a Director/ List of Companies where Depositor is a Signatory
Officer/Stockholder with Related Interest
Company Name Company Name

___________________________________________________________________________ ____________________________________________________________________________

___________________________________________________________________________ ___________________________________________________________________________

___________________________________________________________________________ ___________________________________________________________________________
Existing Accounts with LANDBANK Existing Accounts with Other Banks
Bank Branch Name Account Type
Savings Current Treasury None
_________________________ ________________________ _____________________
Time Deposit Trust Credit Card
_________________________ ________________________ _____________________
Loans Trade With ATM _________________________ ________________________ _____________________

Relationship to Official of Government/International Organization

Full Name Relationship Position Government Branch/Organization Name

_________________________________________ ____________________________ _________________________________ _________________________________________________

_________________________________________ ____________________________ _________________________________ _________________________________________________

_________________________________________ ____________________________ _________________________________ _________________________________________________

iAccess ENROLLMENT
Request for enrollment iAccess Others (please specify) ____________________________________________________________________________________

Account Type* Account** Fund Transfer**

Account Number Bills Payment
Individual (I)/Joint (J) Own 3rd Party Source Destination

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*Indicate (I) if Individual account or (J) if joint account. For joint “and” account, only inquiry services can be enrolled.
**Put a check (✓) mark to whichever is applicable.
Bills Payment (Limited to individual/joint “or” accounts) Note: All enrolled deposit accounts will be activated for Bills Payment feature
Merchant/Agency Subscriber’s Name Reference Number*

*For verification of your reference number, please present your latest Billing Statement from your merchant.
Note: Please indicate “NOT APPLICABLE” or “NA” for fields with no applicable data and “Nothing Follows” immediately after the last item.
I certify that the above information is true and correct. I hereby consent to the provisions of the Republic Act No. 10173 (Data Privacy Act of 2012).

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CIS - Individual | Page 2 of 3 Revised August 2021

 VALID IDS AND DOCUMENTS PRESENTED

ID Type ____________________________ ID Number ___________________________ Document Name ______________________ Document Name ______________________

ID Type ____________________________ ID Number ___________________________ Document Name ______________________ Document Name ______________________

ID Type ____________________________ ID Number ___________________________ Document Name ______________________ Document Name ______________________

For US person under Foreign Account Tax Compliance Act (FATCA) Are you a U.S. Person? YES NO
If yes, please provide the following:
U.S. Address: ZIP Code

U.S. Phone no.: (Area Code + Telephone number) Length of Stay in the U.S. U.S. TIN

I certify that the above information is true and correct. I hereby consent to the provisions of the Republic Act No. 10173 (Data Privacy Act of 2012).

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Validated by: Approved by:

____________________________________________ __________________ ____________________________________________ __________________

Signature over Printed Name Date (mm/dd/yyyy) Signature over Printed Name Date (mm/dd/yyyy)

ACKNOWLEDGMENT SECTION

CTD CARD PASSBOOK CHECKBOOK

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FOR BANK USE ONLY

Approved by: Released by:

____________________________________________ __________________ ____________________________________________ __________________

Signature over Printed Name Date (mm/dd/yyyy) Custodian Date (mm/dd/yyyy)

CIS - Individual | Page 3 of 3 Revised August 2021

 LAND BANK OF THE PHILIPPINES
DEPOSIT ACCOUNT TERMS AND CONDITIONS
INDIVIDUAL AND SOLE PROPRIETOR

The following Terms and Conditions (T&C) shall govern my/our shall be subject to the prior consent of LBP. LBP reserves the shall be made personally by me/us. Representatives are not be used to avail of or to make ATM purchases/transactions
deposit account/s with Land Bank of the Philippines right to impose conditions for its consent as may be reasonable allowed to transact on my/our LBP ATM account. through any of the Visa member banks and accredited
under the circumstances. merchants located at the countries outside the Philippines.
“LBP” and “Bank” shall refer to Land Bank of the Philippines. “I,” In case I/we forget my/our PIN, I/we may request for a That any withdrawal/purchase transacted by me/us outside the
“We,” “me,” “us,” “my,” and “our” shall refer to any person who 11. Lien on the Account replacement from the LBP Branch where my/our Account is Philippines through the use of any of the network channels shall
opens an account with LBP. “ATM Card” refers to the Automated LBP shall have a lien and authority to debit from my/our Account maintained. If, however, I/we believe that my/our PIN has been constitute disbursement from said account in the Philippines
Teller Machine (ATM) Card issued by LBP. for the satisfaction of any obligation owed by me/us due to LBP, compromised, I/we should immediately report to the LBP Branch and a remittance to the acquiring banks/merchants where
its subsidiaries and affiliates (including but not limited to any where my/our Account is maintained for further investigation the withdrawal/purchase transaction was effected, and shall,
These T&C shall govern the use of passbook, checkbook, applicable service charges, fees, and penalties) without prior and change my/our PIN at once. therefore be subject to the applicable laws, governing rules and
ATM Card, LANDBANK Visa Debit Card (LVDC) and LBP’s written notice. regulation of both the Philippines and the country where the
Electronic Banking (e-Banking) facilities and services such as I/We agree to hold LBP and its officers and employees free withdrawal/purchase transaction was made.
PhoneAccess, iAccess, Mobile Banking, etc. including any and 12. Interest Rate and harmless from any and all liabilities, claims, and demands
all amendments thereto, and such other rules, regulations, terms Subject to applicable withholding taxes, the Account shall earn of whatever nature in connection with or arising from any Cash withdrawals/purchase transactions outside the Philippines
and conditions as may be issued by the Bank from time to time. interest at such rate which LBP may compute based on its unauthorized use of the ATM Card and/or disclosure of my/our using the Card shall be in the original currency which is
cleared balance on a monthly or quarterly basis, at LBP’s option. PIN to any person. subject to maximum amount imposed by the LBP and the
By signing on the T&C or my/our use of the passbook, LBP may, from time to time, amend the applicable interest rate institution which owns the ATM/POS/web-based application.
checkbook, ATM Card or LVDC and LBP’s e-Banking facilities without prior notice. The Account shall not be entitled to interest 2. Confirmed Loss/Stolen ATM Card Each successful transaction is subject to transaction fees as
and services, I/we hereby acknowledge and confirm that I/we where it is closed prior to an interest crediting date. I/We should immediately report the loss or theft of my/our ATM determined by the LBP and Visa. The transaction amount and
have fully read, understood and agreed to be bound by these T&C Card and request LBP the immediate blocking of the said ATM the applicable transaction fee are subject to foreign exchange
with respect to my/our deposit account or accounts (“Account” 13. Current Account Card at the LBP Branch where my/our Account is maintained rate prevailing at the time of the transaction.
or “Accounts”). I/We accede to the electronic clearing of checks and hereby or its Customer Care Help desk No. (02) 405-7000 (for Metro
waive the presentation for payment of the original to LBP. Manila) and 1-800-10-4057000 (for Provincial Toll Free). LBP 5. Visa member Banks and Accredited Merchants
1.Account Opening will not be responsible for any loss incurred by me/us before LBP has an agreement with Visa for its card issuing scheme
I/We are free from any legal disabilities when opening an Whenever the Account is mishandled as when the same is LBP’s receipt of my/our notice of loss or theft of my/our ATM whereby the LVDC bearing the Visa label shall be honored by all
Account. overdrawn or whenever an amount is withdrawn in excess of the card with specific instruction to block/hold the Account. Visa member banks and accredited merchants worldwide at all
required minimum balance, I/we obligate to pay LBP the debit times. However, LBP shall not be liable, if for any reason, such
I/We represent and warrant that I/we am/are the true and lawful balance appearing, if any, in the Account and/or LBP’s applicable My/Our request for ATM Card replacement may only be allowed Visa member banks or accredited merchants do not honor the
owner/s of the Account and if another person is opening or service charges. I/We further authorize LBP to close the Account at the LBP Branch where my/our Account is maintained. card or its transaction.
transacting on my/our behalf, he/she is my/our authorized when mishandled and to report the fact of said closure and the
representative, subject to the submission of the documentary reason therefor with the Banker’s Association of the Philippines 3. Deposit via ATM 6. Fees and Charges
requirements of LBP. I/We agree to hold LBP free from any and or any central monitoring entity or body. I/We agree that the receipt electronically generated at the time LBP may, upon posting prior notice, impose reasonable fees,
all damages and liabilities that may arise from any fraudulent I/we made a deposit transaction shall be binding on LBP only charges and penalties for the used/mishandled account. I/
transaction in the account or fraudulent account opened in my/ 14. Stop Payment Orders on Current Account when it has verified that the amount deposited is correct. We hereby authorize LBP to debit from my/our Account the
our name. Stop payment orders may only be honored when filed under amount of such fees, charges and penalties without need for
such form and manner as may be prescribed by LBP and before 4. Unauthorized ATM Withdrawals
further notice or demand. In case of insufficient funds in the said
The Account shall be governed by the present and future LBP’s certification, acceptance or payment of the check sought Loss incurred by me/us from the use of my/our ATM Card found
account to cover the applicable fees, charges and penalties, LBP
rules and regulations of LBP, the Philippine Clearing House for stop payment. to have been compromised at any ATM, shall be restituted after
has the right to suspend, terminate or close the LVDC account
Corporation (PCHC), the Anti-Money Laundering Council, the investigation has been made by LBP which will show that a
without LBP incurring any liability as a result thereof.
Bangko Sentral ng Pilipinas (BSP), and the applicable laws of the Notwithstanding the timely filing of the stop payment order, I/we restitution should be made by LBP.
Philippines, as may be amended from time to time. agree to hold LBP free and harmless from whatever liability that Any and all taxes arising from payment of fees, charges and
may arise when it honors the same. In no case, however, shall the loss arising from unauthorized
penalties shall be borne by me/us.
I/We hold LBP free from any and all damages and liabilities withdrawals be restituted when, for any reason whatsoever, I/
in complying with the requirements of the law, including the I/We also agree that after the expiration of six (6) months from we have voluntarily or thru negligence disclosed my/our PIN I/We understand and agree that any successful transactions
reporting requirement to authorized agencies. the date of stop payment of check, the request for stop payment and/or gave my/our ATM Card to or is in the possession of switched through the BancNet or Visa networks shall be
shall be considered cancelled and should there be any fee another person. subject to transactions fees as agreed by LBP and the networks
2. Joint “AND” Account occasioned by the stop payment, the same shall be charged by concerned.
By opening a joint “and” account, we warrant that we jointly own LBP against my/our Account. ADDITIONAL T&C FOR E.A.S.Y. SAVINGS PLUS (ESP)
the account. Upon withdrawal, all of our signatures are required 7. Card Renewal
in the withdrawal slip. 15. Statement of Account 1. I/We agree to maintain a monthly ADB equal to the prevailing
The card shall be valid up to the “valid thru date” indicated in the
I/We acknowledge that a Statement of Account (SOA) shall be amount set by LBP otherwise, applicable service fee shall be
card. The card shall be automatically renewed by the LBP and
Upon the death of one of us, the share of the deceased co- regularly sent to me/us via postal service at my/our last given automatically debited from my/our Account at the end of the
can be claimed by me/us at the servicing branch of account a
depositor may be withdrawn by the legal heir/representative address unless the same is picked-up by my/our authorized month.
month prior to expiration.
jointly with the surviving depositor, subject to the requirements of representative from LBP Servicing Branch.
the law and that of the Bank. 2. The Bank shall accrue interest earnings daily based on my/
8. Cardholder Complaints
The SOA shall be considered correct should LBP not receive our available balance and the applicable tiered interest rate to
Any complaint regarding the Card, Account, and/or the
3. Joint “OR” Account any written notice to the contrary within ten (10) calendar days be credited to my/our Account at the end of the month. If my/
transactions using the card shall be communicated through
By opening a joint “or” account, we warrant that we jointly after my/our receipt thereof and any claim against LBP shall be our end-of-day available balance falls below the minimum tiered
the LBP’s Customer Care Hotline or its servicing branch. In
own the Account and the Bank recognizes the existence of considered waived. ADB, interest earnings shall be computed based on the interest
case of dispute, I/we shall attach the duly accomplished Client
a survivorship agreement between us. Either one of us may rate for regular Savings Account. However, if my/our end-of-day
Complaint Form (CCF) if transaction is routed to BancNet Switch
encumber, pledge or even withdraw the entire deposit without 16. Updating of Account available balance falls below the required minimum balance for
and Transaction Dispute Form (TDF) if transaction is routed
the knowledge, consent and signature of the other. I/We shall promptly notify LBP in writing of any change in regular Savings Account to earn interest, my/our Account shall
to VisaNet.
official mailing/e-mail address, contact number/s or source of not earn any interest at all.
Upon the death of one of us, the surviving co-depositor may funds whenever necessary, and shall personally fill out a new 9. Amendments/Revision
withdraw the balance of the deposit subject to the requirements Specimen Signature Card as may be required by LBP. 3. I/We may deposit any additional amount to my/our Account
I/We agree that LBP shall have the right to add, revise, or amend,
of the law and that of the Bank. after account opening. However, I/we are allowed only two (2)
in whole or in part, these T&C, and the features/functionalities
17. Anti-Money Laundering withdrawals of any amount on my/our ESP Account during
4. Deposits of the LVDC. Such amendments and revision shall be in effect
I/We warrant that the funds deposited are not proceeds of a calendar month. Service fee shall apply to succeeding
The Bank may credit to my/our Account any cash and check and shall be binding on me/us from such time that the same is
any criminal or illegal activity. The Bank reserves the right to withdrawals which shall be charged to my/our Account.
deposit upon presentation of duly accomplished deposit slip announced, published, posted in conspicuous places within the
close my/our Account without prior notice or consent if there is
and only after its proper verification. Checks shall be accepted 4. My/Our Account shall be subject to applicable service fee if it premises of the LBP.
reasonable ground to believe that the funds are proceeds of a
for deposit on collection basis and may be withdrawn only when criminal or other illegal activity. is closed within thirty (30) days from opening date.
All existing T&C of the deposit accounts not inconsistent with the
cleared through the clearing house.
ADDITIONAL T&C FOR TIME DEPOSIT ACCOUNT provisions stipulated under the foregoing additional T&C shall
I/We hold LBP, its officers and employees free and harmless
In receiving items for deposit, LBP’s obligation shall only be that remain in force and effect.
from whatever liability that may arise should I/we and/or the
of a collecting agent and LBP assumes no responsibility beyond Account be made subject to the applicable provisions of the 1. I/We agree that this deposit shall earn interest based on the
the necessary diligence in selecting correspondents. Until such Anti-Money Laundering Law, as amended, such as but not rate specified in my/our Time Deposit Certificate.
time an actual payment shall have come to its possession, LBP I/We hereby read, understood and agreed to be governed
limited to transaction reporting, investigation, prosecution,
reserves the right to charge back the Account for any amount 2. I/We must present the properly endorsed certificate upon by the foregoing T&C and the attached Deposit Account
asset preservation and/or forfeiture by applicable government
previously credited. This reservation shall also apply to checks applying for withdrawal of my/our deposit and surrender the Information.
authority, as the case may be.
drawn on LBP which are not paid because of insufficiency of same upon repayment of the amount.
Where an Account is opened jointly with another, my/
funds, forgery, unauthorized overdraft, stoppage or any other I/We hereby agree to hold LBP free and harmless from any 3. In case of pre-termination, I/we shall give a written notice to our rights and obligations therein shall be jointly and not
reason. and all damages and liabilities arising from technical errors LBP seven (7) days prior to my/our withdrawal. solidary.
committed by LBP in the processing of transactions except
Whenever improper or erroneous credit is made on the Account, if the same is due to the gross negligence of LBP or any of its 4. Unless presented on the date of maturity for withdrawal, LBP
LBP shall, without prior notice and regardless of the intervening employees. shall dispose of my/our deposit in accordance with the Time
time that has elapsed be authorized to debit back any item Deposit Renewal Instructions I/we signed upon placement.
previously credited. 18. Deposit Insurance
My/Our Account or Accounts shall be insured against such risks 5. Other T&C applicable to Time Deposit Account are
5. Interbranch Deposit and to such extent as may be prescribed under the applicable incorporated in the certificate.
Interbranch deposit is allowed subject to LBP’s existing policy. PDIC laws, rules and regulations, and any and all amendments
thereof that may be issued in the future. ADDITIONAL T&C FOR LANDBANK e-BANKING
6. Passbook ____________________________________________________________
FACILITIES & SERVICES
Where the Account is Passbook-based, I/we agree that nothing 19. General/Special Power of Attorney
shall be written therein which are not authorized by LBP. LBP I/We agree to comply with the requirements of LBP in the By maintaining my/our Account or Accounts with LBP, I/we Signature Over Printed Name
shall not be responsible for any sum recorded therein without acceptance of special and general powers of attorney or written am/are eligible to enroll my/our Account or Accounts with
LBP’s authorization. In the event of any discrepancy between authorizations issued in favor of other persons to act in my/ LANDBANK e-Banking facilities and services such as iAccess,
the entries in the Passbook and the LBP’s records, the latter our behalf. Phone Banking, Mobile Banking, etc., subject to the laws, rules,
shall prevail. _____________________________________________________
regulations and official issuances applicable to the e-Banking
20. Closing of Account Facilities, and any or all amendments thereof that may be issued Date
The Passbook is not assignable or transferable. The Bank shall I/We acknowledge that LBP has the right to close the Account in the future.
have the right to presume that the presenter of the Passbook at its sole discretion at any time if the Account is without
is my/our duly authorized representative/s. I/We acknowledge any outstanding balance, turns out to be fictitious, used ADDITIONAL T&C FOR LANDBANK Visa DEBIT CARD (LVDC)
that LBP possesses no obligation to indemnify me/us for for fraudulent purposes or for any reason that LBP deems
unauthorized payments made on the Account prior to LBP’s necessary to protect its interest. 1. ATM Transactions
receipt of notice of its loss. I/We understand that the LVDC may be used to avail any of the
21. Miscellaneous applicable ATM services of BancNet and Visa member banks. I/
Loss or destroyed passbooks may be replaced by LBP upon I/We attest that the information provided herein are true, correct We also understand that LBP does not have any control over the
prior payment of applicable fees and compliance with its and voluntarily given. LBP is authorized to give information on ATMs or the communication networks of said member banks.
documentary requirements. the Account to appropriate agencies in case of questionable Hence, LBP shall not be held liable for any loss or damage which ____________________________________________________________
implementation thereof, and represent and warrant that the I/we may incur as a result of my/our inability to use the LVDC
7. Withdrawals Signature Over Printed Name
opening of the Account and all transactions made thereon due to system breakdown or failure of the ATMs or the network’s
Withdrawals from the Account shall only be allowed by LBP upon are not in violation thereof. I/We acknowledge that LBP is duly communication facilities, or unauthorized or fraudulent access
presentation of a duly accomplished withdrawal slip and, where bound to comply with certain requirements under the law such or utilization of the Card.
the Account is Passbook-based, the Passbook. as records management, reportorial requirements, disclosure _____________________________________________________
of certain information about the Account and transactions 2. Card Present Transactions (Point-of-Sale and Pre-
I/We agree that only checks/withdrawal slips containing
pertaining thereto, and in connection therewith, hereby holds authorization) Date
signatures in ink or other means of writing with a character of
LBP free and harmless from any and all liabilities, claims and/or I/We understand that the card maybe transacted through any
permanence which can be verified by LBP shall be honored.
damages that may arise therefrom. of the POS terminal of the accredited merchants of the BancNet
8. Interbranch Withdrawal (local) and Visa (local and international) to pay for goods or
I/We hereby authorize LBP, a banking institution duly organized services at retailers or suppliers who accept it. I/We hereby Account Number:
Interbranch withdrawal is allowed subject to LBP’s existing
and existing under and by virtue of the Provision of RA 3844, as authorize LBP to debit from the account the amount of every
policy.

9. Dormant Account
amended, with principal office at the LBP Plaza, 1598 M.H. del
Pilar St. cor. Dr. J. Quintos St. Malate, Metro Manila, Philippines
successful transaction. Hence, LBP shall not be held liable for
any unauthorized or fraudulent utilization of the Card, or for any
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The Account shall be considered DORMANT when it becomes to inquire and make verification with any bank, financial or defective products or service purchased through the use of the
inactive (no deposits or withdrawals) for a period of two (2) years lending institution whether juridical or otherwise as to the state Card or for any dispute between me/us and the establishment. Distribution: 1 - Branch’s copy 2 - Client’s copy
for Savings Account and one (1) year for Current Account. and condition of any and all kinds of accounts I/we keep and
maintain with any or all of them, and I/we hereby waive my/our 3. Card-Not-Present Transactions (Online Payment, Mail Order/
The Bank shall impose a monthly service charge on dormant rights to the secrecy thereof. Telephone Order and Recurring Payment)
account if the balance falls below the required minimum balance. I/We understand that the LVDC may be used for debit
ADDITIONAL T&C FOR LANDBANK ATM ACCOUNT transactions through any of the web-based/remote
The Account may further be reported to the Treasurer of the applications which may be offered by BancNet or Visa or any
Philippines as an unclaimed balance under the Unclaimed I/We acknowledge that the LBP ATM Card is and shall remain of their participating merchants. I/We further understand
Balances Law (Republic Act No. 3936, as amended) where the property of the LBP, and is subject to revocation and/or that LBP authorizes debit from the account after verifying the
it becomes inactive for ten (10) consecutive years. For the repossession by LBP upon notice for violation of any of the T&C withdrawable balance, card number, expiry date and the Card
avoidance of doubt, accounts subject to rollover may be stated herein and for any other reason/s, which in the opinion of Verification Value (CVV). Hence, LBP shall not be held liable for
considered inactive for purposes of the Unclaimed Balances Law LBP, would prejudice my/our or LBP’s interests arising from the any unauthorized or fraudulent utilization of the Card or for any
even in cases where a previous authority to have it automatically continued use of the ATM Card. I/We agree to return the Card defective products or service purchased through the use of the
rolled over was issued to LBP for as long as no deposits or to LBP upon its request. I/We further agree that LBP may cause Card or for any dispute between me/us (as cardholder) and the
withdrawals have been made at the instance of the Depositor the ATM to retain the Card automatically at any time and without merchant.
(other than through the previous authority issued to LBP to effect notice to me/us.
automatic rollover). 4. Access to ATM/POS located outside the Philippines, and Web-
1. Personal Identification Number (PIN) Maintenance based application owned by Foreign merchants
10. Pledge or Assignment of Account My/Our PIN is/are strictly confidential and under no I/We understand that LVDC is a peso current/savings account
The pledge or assignment of the Account or any amount therein circumstances be disclosed to any person. All ATM transactions maintained with the LBP. It bears the Visa logo which can
 DATA PRIVACY CONSENT FORM FOR DEPOSITORS

I/We authorize Land Bank of the Philippines, its subsidiaries, agents, representatives, and outsourced service
providers (“Bank”), to collect, process, update or disclose personal information about me/us in accordance with
the Data Privacy Act, its Implementing Rules and Regulations (IRR), Bank’s Data Privacy Statement, and bank
secrecy laws, to verify, my/our personal information from any person or entity that the Bank may deem necessary
including, but not limited to, credit bureaus, financial institutions, and government authorities, to establish, confirm,
review or update my/our record, manage my/our account and/or services provided to me/us, to conduct customer
risk, capacity and suitability assessment, product development and audit, to market its products and services, and
other legitimate business purposes, and to comply with its reporting obligations under applicable laws, rules and
regulations.
I/We agree to hold the Bank and the persons or entities from whom it may obtain, or with whom it may disclose
or verify my/our personal information free and harmless from any liability arising from the use of any such
information.
I/We confirm that I am aware that under the Data Privacy Act, I have (a) the right to withdraw the consent hereby
given or to object to the processing of my personal information provided there is no other legal ground or overriding
legitimate interest for the processing thereof; (b) right to reasonable access, (c) right to rectification, and (d) right
to erasure or blocking of my personal information subject, however, to the conditions for the legitimate exercise of
the said rights under the Data Privacy Act and its IRR, and subject further to the right of the Bank to terminate the
product or service availed by me should I withdraw my consent or request the removal of my personal information.

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