Date and time of receipt

THE PHILIPPINE STOCK EXCHANGE, INC.

PSE Tower, One Bonifacio High Street
28th Street corner 5th Avenue, Bonifacio Global City, Taguig City
Tel. No. 876-4888
Website: http://www.pse.com.ph
EDGE Website: http://edge.pse.com.ph

RENEWAL FORM FOR RSA SECURITY TOKEN

(PSE EDGE RSA Form-02)

INSTRUCTIONS
1. The Renewal Form for RSA Security Token will be accomplished by the System Administrator for each listed company
authorized user.
2. Completely fill-out the Renewal Form for RSA Security Token. Incomplete forms will not be processed.
3. Upon completion of items 1 and 2, submit the form to the Disclosure Department.
4. Only the System Administrator shall be recognized as the signatory on the Authorized Officer section of this request form.
5. The System Administrator will be notified once the RSA Security Token is available for pick-up.
6. Only the System Administrator or his/her authorized representative shall be allowed to pick up the RSA Security Token.
The authorized representative should bring a valid ID, authorization letter and a valid ID of the System Administrator.
Acceptable valid IDs include: Company ID, Passport, Driver’s License, PRC ID, SSS ID or other government-issued IDs.
7. By submitting this form, the System Administrator, users, and authorized representative consent to the collection,
recording, storage, use, disclosure, and processing by the PSE of their personal and sensitive personal information for the
purpose of the RSA Security Token application and for purposes relevant or incidental thereto.
8. For inquiries, call the Disclosure Department at 876-4740 to 4745.

APPLICANT’S INFORMATION
Listed Company:

System Administrator: Telephone No. Email Address:

Signature Date:

RENEWAL OF RSA SECURITY TOKEN

User:
User ID:
 RENEWAL FORM FOR RSA SECURITY TOKEN
Page 2 of 2

FOR PSE USE ONLY

Received by:
Date Received:

PSE EDGE RSA Form-02

Control Number: RSA ____________