CST-HC-004 Revision0110192018

CREDIT-TO-ACCOUNT INSTRUCTION FORM

NAME OF MEMBER
FIRST NAME

MIDDLE NAME

SURNAME

RESIDENCE ADDRESS
(No., Street, District, City, Province, Country)

CONTACT DETAILS
Residence Mobile Number (s)
(Area Code) (Telephone Number)

Office E-Mail Address:

(Area Code) (Telephone Number)

I hereby authorize Home Credit Mutual Building and Loan Association, Inc. (”HCMBLA””) to credit and/or cause the crediting of the proceeds of
all my financial transactions with HCMBLA to my Bank Account, the details of which are more specifically set out below:
Bank Name: Branch of Account:

Account Denomination: Peso Dollar Type of Account: Savings Checking Joint Account
Bank Acct No. Account Name:

I certify that I am a member of HCMBLA and that I am the Account Owner of the aforementioned Bank Account. I acknowledge that any credit or deposit
made by HCMBLA of the benefit or amount due to me to the bank account I have designated above is authorized, and that I shall release and forever
discharge HCMBLA of and from all actions, claims and demands on all matters involving said benefit or amount. Further, I certify the correctness and
accuracy of the above information I provided. Moreover, HCMBLA will be informed in writing of the future changes of the above information.

Furthermore, I acknowledge that deposit of the amount agreed and its corresponding validated deposit slip or transaction detail in the HMBLA’s bank
statement is proof of full redemption /withdrawal value of my shares and/or the loan proceeds as agreed with HCMBLA and that I hereby remise, release and
forever discharge and agree to hold harmless HCMBLA and its Board of Directors, Officers, President, Executive Officers, Managers, Supervisors, Agents,
Successors and assigns from all debts, claims, demands, damages, expenses, losses, injuries, actions and all causes of action whatsoever in law of equity, by
me or through my heirs, assigns, successors, agents and attorneys, as well as future developments thereof, including but not limited to the foregoing such as
may have arisen or may hereafter arise by reason of or in any manner growing out of the Agreement to Subscribe with HCMBLA.

Signed at__________________________ this _____________________ day of _________________________, 20 _____.

Conforme:
Name & Signature of Member