LAND BANK OF THE PHILIPPINES

Zamboanga Veterans Branch

weAccess ENROLLMENT AND MAINTENANCE AGREEMENT FORM

INSTITUTION PROFILE
Name of Institution Short Name
Sanguniang Panlungsod MPC SPMPC

Address ZIP Code Country

SPCMPC Ground Floor, Ruste Drive San Jose Cawa-Cawa Zamboanga City, ZDS 7000 Philippines
No. Street Barangay/District Municipality/City Province

Contact Number Fax Number Tax Identification Number (TIN) Date of Incorporation
(062) 955-2447 005 ### 843 - 684 - 000 - -
Area Code Telephone Number Ext. Area Code Telephone Number M M D D Y Y Y Y

BIR Registered Name Institution's Email Address1/ Client Type2/

SP Community Multi-Purpose Cooperative [email protected] Cooperative

SUBSIDIARIES
INSTRUCTIONS INSTITUTION NAME TAX IDENTIFICATION NUMBER (TIN)
- - -

- - -

THIRD PARTY ACCOUNTS

As Fund Transfer Destination
INSTRUCTIONS ACCOUNT TAG3/ ACCOUNT NUMBER
- -

- -
As Auto-Debiting Source
INSTRUCTIONS ACCOUNT TAG3/ ACCOUNT NUMBER
- -

- -

BILLS PAYMENT
INSTRUCTIONS MERCHANT NAME REFERENCE NUMBER
PHILHEALTH 014000000212

CHARGES (if any)

Total Number of weAcess USB/flash disk: Please put N/A if Not Applicable. Total Billing:
Cost of weAccess USB/flash disk in excess of three (3)
Cost of weAccess USB/flash disk Replacement
Cost of weAccess vToken Application

ACKNOWLEDGMENT
This serves as our application to your LANDBANK weAccess Facility. I/We hereby acknowledge to have read, understood and agreed to be bound by
the Terms and Conditions of the LANDBANK weAccess facility.

Mary abigail t. borromeo

Signature over Printed Name of Authorized Signatory Date

FOR BANK USE

SERVICING BRANCH/EO SYSTEMS IMPLEMENTATION DEPARTMENT

Reviewed by Verified by Approved by Checked by Enrolled by Date

Distribution Copy 1 - SID Copy 2 - Institutional Client Copy 3 - Depository Branch

Notes: (1) Please write "Not Applicable" or "N/A" for fields with no applicable data and/or "Nothing Follows" immediately after the last item.
(2) Please use additional sheets, if necessary.

1/
The designated email address where notices from the weAccess Facility shall be sent.
2/
e.g. GOCC, NGA, LGU, Private Corporation, Partnership, Cooperative, SME, Educational and Health Institution, Development Partnet, Religious and
Charitable Organization, Commercial/Universal Bank, Thrift Bank, Rural Bank, Other Financial Intermediary, NGO/People Organization/Association,
Micro-Enterprise, Sole Proprietorship
3/
The designated account description with a maximum of 15 alphanumeric characters (e.g. Payroll Account).
page 1
 ACCOUNT ACCESS PROFILE

INSTRUCTIONS ACCOUNT NUMBER ACCOUNT TAG1/

- -

AUTO CREDITING REQUEST AUTO DEBITING REQUEST

Authorization Rule Amount Range Authorization Rule Amount Range

ATM PAYROLL BILLS PAYMENT

Authorization Rule Amount Range Authorization Rule Amount Range

ACCOUNT TAG MANAGEMENT REMITTANCE

Authorization Rule Amount Range Authorization Rule Amount Range

FUND TRANSFER CURRENT ACCOUNT SERVICES

Source Account Destination Account Checkbook Reorder
Authorization Rule Amount Range Authorization Rule Amount Range

FUND SWEEPING Mother Account Satellite Account

INWARD SWEEP OUTWARD SWEEP

(Group, Scheduled, Manual Inward Sweep Request) (Group, Outward Sweep Request)
Authorization Rule Amount Range Authorization Rule Amount Range

REPORTS Downloadable Reports Viewable Reports

Salary Related Reports Adhoc Reports - Bills Payment Gov't. Merchant Reports
ePayments Reports Loan Profile Reports Others

INSTRUCTIONS ACCOUNT NUMBER ACCOUNT TAG1/

- -

AUTO CREDITING REQUEST AUTO DEBITING REQUEST

Authorization Rule Amount Range Authorization Rule Amount Range

ATM PAYROLL BILLS PAYMENT

Authorization Rule Amount Range Authorization Rule Amount Range

ACCOUNT TAG MANAGEMENT REMITTANCE

Authorization Rule Amount Range Authorization Rule Amount Range

FUND TRANSFER CURRENT ACCOUNT SERVICES

Source Account Destination Account Checkbook Reorder
Authorization Rule Amount Range Authorization Rule Amount Range

FUND SWEEPING Mother Account Satellite Account

INWARD SWEEP OUTWARD SWEEP

(Group, Scheduled, Manual Inward Sweep Request) (Group, Outward Sweep Request)
Authorization Rule Amount Range Authorization Rule Amount Range

REPORTS Downloadable Reports Viewable Reports

Salary Related Reports Adhoc Reports - Bills Payment Gov't. Merchant Reports
ePayments Reports Loan Profile Reports Others

ACKNOWLEDGMENT
This serves as our application to your LANDBANK weAccess Facility. I/We hereby acknowledge to have read, understood and agreed to be bound by
the Terms and Conditions of the LANDBANK weAccess facility.

Signature over Printed Name of Authorized Signatory Date

Notes: (1) Please write "Not Applicable" or "N/A" for fields with no applicable data and/or "Nothing Follows" immediately after the last item.
(2) Please use additional sheets, if necessary.
1/
The designated account description with a maximum of 15 alphanumeric characters.
page 2
 LAND BANK OF THE PHILIPPINES
Zamboanga Veterans Branch

Name of Institution Short Name

Sanguniang Panlungsod MPC SPMPC
USER PROFILE
Name

First Name Middle Name Last Name

Address ZIP Code Country

No. Street Barangay/District Municipality/City Province

User ID Position/Designation Gender Date of Birth Date of Birth E-mail Address
- -
M M D D Y Y Y Y
vToken ID Contact Number/s Civil Status Tax Identification Number (TIN)
NA Landline Mobile
Single Divorced - - -

Challenge Questions Married Separated FOR BANK USE ONLY

1. Mother's Complete Maiden Name Widowed Internet Password Mailer ID
2. Name of High School - - -
3. Grandfather's Name
INSTRUCTIONS USER TYPE1/ ACCOUNT NUMBER ACCESS RIGHTS (pls. check applicable modules)
Account Information Fund Transfer Current Account Services
- - ATM Payroll Bills Payment Report
Remittance Fund Management2/ Loan Profile
ACIC File Upload ECNOW Access

INSTRUCTIONS USER TYPE1/ ACCOUNT NUMBER ACCESS RIGHTS (pls. check applicable modules)
Account Information Fund Transfer Current Account Services
- - 1 ATM Payroll Bills Payment Report
Remittance Fund Management2/ Loan Profile
ACIC File Upload ECNOW Access
INSTRUCTIONS USER TYPE1/ ACCOUNT NUMBER ACCESS RIGHTS (pls. check applicable modules)
Account Information Fund Transfer Current Account Services
- - ATM Payroll Bills Payment Report
Remittance Fund Management2/ Loan Profile
ACIC File Upload ECNOW Access

INSTRUCTIONS USER TYPE1/ ACCOUNT NUMBER ACCESS RIGHTS (pls. check applicable modules)
Account Information Fund Transfer Current Account Services
- - ATM Payroll Bills Payment Report
Remittance Fund Management2/ Loan Profile
ACIC File Upload ECNOW Access

INSTRUCTIONS USER TYPE1/ ACCOUNT NUMBER ACCESS RIGHTS (pls. check applicable modules)
Account Information Fund Transfer Current Account Services
- - ATM Payroll Bills Payment Report
Remittance Fund Management2/ Loan Profile
ACIC File Upload ECNOW Access

INSTRUCTIONS USER TYPE1/ ACCOUNT NUMBER ACCESS RIGHTS (pls. check applicable modules)
Account Information Fund Transfer Current Account Services
- - ATM Payroll Bills Payment Report
Remittance Fund Management2/ Loan Profile
ACIC File Upload ECNOW Access

ACKNOWLEDGMENT
This serves as our application to your LANDBANK weAccess Facility. I/We hereby acknowledge to have read, understood and agreed to be bound by
the Terms and Conditions of the LANDBANK weAccess facility.

Signature over Printed Name of User Signature over Printed Name of Authorized Signatory Date

FOR BANK USE

SERVICING BRANCH/EO SYSTEMS IMPLEMENTATION DEPARTMENT

Reviewed by Verified by Approved by Checked by Enrolled by Date

Distribution Copy 1 - SID Copy 2 - Institutional Client Copy 3 - Depository Branch

Notes: (1) Please write "Not Applicable" or "N/A" for fields with no applicable data and/or "Nothing Follows" immediately after the last item.
(2) User ID must be composed of 6-8 alphanumeric characters, letters using upper cases only. The number zero should be written as "Ø"
to differentiate from the letter "O".
(3) Vtoken ID must be composed of 8 alphanumeric characters. The number zero should be written as "Ø" to differentiate from the letter "O".
1/
Authority of the designated user.
2/
Fund Management includes Auto Crediting, Auto Debiting and Fund Sweeping Modules. page 3