ENROLLMENT FORM

COMPANY INFORMATION
Business Name / Full Name
Contact Person
Contact Details (e-mail address required)
ACCOUNTS AND FACILITIES
Please provide information regarding the company accounts you wish to enroll.
ACCOUNT NUMBER ACCOUNT NAME

ACCOUNT NUMBER/S
The following facilties will be made available in BizLink. If you are enrolling more than one account,
FACILITIES please indicate the account number/s to be used for each facility. If left blank, all accounts will be
enrolled to all facilties.

✘ Deposit Account Inquiry

✘ Transfer to Own Accounts*
✘ Pay Employees
✘
Pay Bills
✘
Pay BPI Accounts
* only for 2 or more accounts of the same currency
Funding Account Number
✘ BIR Payment Tax Identification Number/s
There can only be 1 funding account per TIN.

Funding Account Number

Employer ID Number/s

✘ Pag-ibig Payment Employer Name

Employer Branch / MSB Code

Employer Address

Funding Account Number

Philhealth Payment Employer ID Number/s

Employer Name
Funding Account Number

✘
SSS Payment Employer ID Number/s

Locator Code

USER ENROLLMENT For Corporates or Partnerships, nomination should be supported by a Corporate Secretary's
Certificate or Partnership Resolution.
Role: System Administrator (SA) - Encoder
Last Name First Name Middle Name

Email Address: Mobile Number:

Tax Identification Number (TIN):
Role: System Administrator (SA) - Approver
Last Name First Name Middle Name

Email Address: Mobile Number:

Tax Identification Number (TIN):

Authorized Signature/s over Printed Name

 ENROLLMENT FORM

PRICING
In connection with our enrollment to the Cash Management facilities of the BANK, the COMPANY
hereby agrees to the following pricing and payment arrangements:

Payment of a monthly service fee of Php

I / We understand that the fee shall be debited against the account indicated herein.

Maintenance of a monthly deposit average daily balance (ADB) in the COMPANY's deposit account
(the "Account") with the following terms:
Php
Number of Employees:

AGREEMENT
By signing this form, we confirm the validity and accuracy of all information provided to the BANK and that the
approval set-up herein contained fully conforms with the COMPANY'S latest and updated Board Resolution or
Secretary's Certificate.
We agree to update the BANK of any changes relating to such information from time to time including changes affecting
the user profiles and their authorities. The BANK shall not be responsible for our failure to update this form.
We further warrant that, prior to submitting to the BANK information about individuals related to the COMPANY
(including directors, officers, beneficial owners, customers, authorized signatories, employees, users and approvers of
the Facilities), we have obtained all necessary authorizations and consents as may be required by applicable
confidentiality and data privacy laws or agreement, for the BANK to process, use and disclose the information
necessary to enable it to perform the services and provide the Facilities under the Cash Management Agreement.
This form, as the same may be amended or supplemented from time to time, shall form part of the Cash
Management Agreement entered into between the COMPANY and the BANK.

Authorized Signature/s over Printed Name