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Sample BDO Form Filled Up

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Carl Anthony Miguel Alcazar
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2K views2 pages

Sample BDO Form Filled Up

iiii

Uploaded by

Carl Anthony Miguel Alcazar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Cash Card Enrollment Form ‘Complete the Cash Card Enrollment Form. All elds must be filled out. not applicable, put NA. ‘Write your name and sign on the Data Privacy Act Consent (page 3) Date fy New Card No. (Olé Car No. Fo Replacement) aah Card CIF No “iA (| Company | Reta Company Name BDO Brench _ MetRd PACING TOLL WAYS CORPORATION = _ Parpore Cardholder Type Personal Use [| Corporate [_] Others (| Purchaser/Cardholder [| Recipient (Supplementary or Third Party) Relationship: _ Primary CCA: Purchaser / Cardholder Information Full Net Nae, Midd Nore Las Na Name to appear on card nto send 25 carta) JUAN _SANtos_DeLa CAuz _suaw pera cave Birthday (meses) Pracect Birth Ciy/Poincs) Present Addrest (io, Set, bdr Branguy/DscV Torey Prone, Coury Zp Coe) wy sas (vans TONDO MANILA 144 SARANGAY SAW OSE TONDO, MANILA, PHILIPPINES t0¢ Home Phone Number ‘Mobile Numbers PajmanentAddres io, Stee, Subdvsen/Bangy/Dsti/Towe/iy Poin, Coun, ZipCode) (imncages LandineNmba) ee Mabe Na) [Cheek t some e present edaross NIK OUHATPT3 1A — ae Lt / Nationality Gi stots othe? Maiden Name Fatma Middle Nave Lae Nene) Filipino: A Single Married Otro: ——____ lowers __J ANA _REYES SANTOS “Toxidntficstion Number TN) SSS/GSIS Number ame of EmpoyerBusiness Fattoat TW, ndiate reason: without SSS/GSS, indicate teayor ‘isioss Aarons (Suden ‘Student lee cor eee Work/Business Phone Number/s E-mail Address Housevite Howse Husband) Hourewife/House Husband Non-eident = Nonresident © Unemployed/Beneficiary Unemployed /Benefciary Job Tile or Nature of Work (it eployed) / Nature of Business (ts empioved) (Oversees sino Worker (OPW) Oversaae pio Worker OFM) 7 Others an 1D/s Presented (Indicate Type of 10) Specie Specie Source of Funds = Salary Business ‘Allowance [—] Commission ID Numbers (if 0 presented is not TIN or SSS/GSIS)_ Pension |_| Remittances |_| Investments [ ] Others: 3 Recipient Information (if Cash Card is to be given for Supplementary or to Third Party ~ to be accomplished by Purchaser) Full Nave Ft Nar, Mi Nor at Na) "Name to appear on card ot once 5 hres) Birthday (mm/cel'yyyy) "Place of Birth (City/Province) Present Address (No., Street, Subdivision/Berangay/Distict/Town/City/ Provines, Country, Zip Code) / s ome Phone Number Mobile Numbers Permanent Address (i, Sv, Subhian rary / Downy Proven Country, ZipCode) (fenade Lardner) PrefieMcbue No) Check sama present ress Nationality CivilStatus Mother's Maiden Name (First Name, Middle Name, Last Name) [Ftp Single] Married Deters: Somers: Texidentfcation Number (TN) SSS/@SIS Number Name of Employer Business ifwihow TN. indiate reason: witout SSS/GSI, indict . ne ausiness Adress student ] Student Vine ee een Work/Business Phone Number/s E-mail Address: “| Housewife/House Husband (| Housewife/House Husband Nen~esident, Cl Non-esdent - Unemployed/Benefciary _—|Unemployed/Benefciary Job Tile or Nature of Work employed / Nature of Business fea elo) cvertes Fipino Worker (°¥) | Overtees iino Worker ORM Flothers others {D7ePresonted Gneicat Type of10) oa —— Specity Speci. Source of Funds oe Salary (Business [| Alowance [_] Commission 1D Numbers 10 preertedienot Tor SSS/GS) | Pension [1 Remittances |_| investments [_] Others: ‘Specimen Signature (Pleose,sign Sx) ied Cork: Cro: Con 2) The Cardholder has broached these Terms and Conditions: ) 00 teams of the Cardholder's bankruptcy, insoWency, lquidetion, lssolution, desth, incapacity, or other analogous circumstances, of that tho Cardholder committed an ect of bankruptey, insolvency, liquidation, dissolition or other analogous acs, or that a bankrupt oF insolvency or other analogous petition has been filed against the Cardholder, «) in BDO's reasonable opinion, the Cesh Card is being used for any ‘unlawful or ilagal activity or transaction; 4) BOO considers that there exist other reasonable grounds todo se. 113 Any and all accrued but unpaid obligations ofthe Cardholder to BDO prior te termination, and terms and conditions hereof which by express terms, shall survive the termination ofthe Cercholde's right to use the Cash Card. {2 AMENDMENT. BDO rotorvee the right to amend the Cath Card Forme and Terms snd Conditions and any such amendment shall be binding upon the Cardholder upon natice (by publication, or other means of communication, electronic or otherwise). 18. UNDERTAKING. In case of overcredit, erroneous creditor mispostng of any ‘|mount 9 Cardholder's Cash Card as appearing in the records/bcoks of BDO, ‘and for whatever cause such as but not limited to systems error, etrr in ‘communication facilites, Cardholder hereby agrees and undertakes to immediately return to BDO the overereit, eranaous credit or misposted ‘amount. For this purpose, Cardholder irrevocably authorize 8DO/ite representative, without need of notice er demand upen the Cardholder, 0 immediately freeze or put on hold the affected Aecount/s and/or effect the \debiting of funds rom the Cash Card tothe extent ofthe overcredit, erroneous Credit, oF misposted amount, and without BDO/its representatives incurring any lability a¢ 2 consoquonce thereof. This is without prejudice tothe exercee by BOO af its right to enforce ful recovery and callaction ofthe overcredt, ‘erroneous creditor misposted amount (lus intrest at 800's then prevailing interest rato on loans of similar amount and costs of collection incase the Cardholder's Cash Card cannot be debited for any reason such a8 but not liited to insuffciont balance, as wall as the exercise by BDO of other legal remedies towhich BDO may be entitled to under the law and ths Agreement, including but net limited to immediate canceletion or suspension of the relevant Cash Card, cv criminal and/or administrative remedies. Pending ful recovery erealection by BDO of the overeredt, erroneous creditor misposted mount, the Cardholder shal hold the said amount in trust for BDO. Failure of Cardholder to account for and return the overcredt, erroneous credit oF mmisposted amount to BDO shall give rise to a prima facie presumption of misappropriation or cerwersion with intent to defraud, on the part of Cardholder 14, LIMITATION OF LIABILITY. Without prejudice tothe provision of Section 6 and Section 18 hareo, the Cardholder agrees that 800s liabilt for any lass or damage thatthe Cardholder may incur under this Agreement or from the Use ‘of the Cash Card shall in no case exceed the amount of P¥0,000.00 or the sctual damege, whichever is lower. Any claim or complaint relative to any ‘Gash Card transaction under the provision of this paragraph, must be presented within tan (10) days from the date of such transaction, otherwise, it shall be deemed irevocably waived. This provision shall survive the termination or suspension of the right to use the Cash Card. 18, NON-LIABILITY. 800 shall not be liable for any loss or damage of whatever ‘nature in connection with transactions involving the Cardholder's use of the Cash Card, including but not limited to any of the fllowing instances: ()

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