POS RENTAL FORMS

REPLY SLIP
This is to signify our interest in being assigned a BPI point-of-sale terminal for our outlet/s. We would be needing_____ unit/s of POS
terminals.
Dial-Up Unit GPRS Desktop GPRS Mobile
Monthly Rental Fee
One Time Security Deposit (equiv to 3 months)
refundable
No. of Units Required
Security Deposit
Total Amount for 1st month

We would like to pay our POS rental via:

 Automatic Debit Arrangement (via Elink ADA Facility). Please read, sign and return the attached ADA Enrollment form to Merchant
Specialist.

Account Name √
Account Number SA CA √

 Check Payment

Amount Check Number/s

1st Month + Security Deposit P
11 Months Rental Fee P

The first monthly POS Rental fee payment plus the security deposit will be effected on _____________________.

TERMS AND CONDITIONS FOR POS RENTAL ARRANGEMENT

1. The POS Rental agreement effective_____________ is in force for a year and subject to automatic renewal for another year unless either party gives the other written notice at least
ninety (90) days prior to the end of the term.

2. The monthly rental fee will be collected every 1st banking day of each month, and the security deposit will be refunded upon return of the POS terminal to BPI.

3. Payment Option:

3.1 Credit Card - This serves as an authorization to charge our BPI/MC/Visa Card. We understand that we need to advise BPI Merchant Sales of any changes in the card
details ten (10) days prior to the scheduled collection of the monthly POS rental fee.

3.2 BPI Savings/Checking Account - This serves as an authorization to debit our BPI SA/CA Account. We agree and shall be bound by the Terms and Conditions for
Enrollment under BPI’s Auto Debit Arrangement (Please see attached E-link ADA Enrollment form).

3.3 Check Payment - We agree to pay via one dated check for the 1st month’s rental fee plus the 3-month advanced deposit, and 11 postdated checks to cover the next
11 months rental fee.

4. In the event that we fail to settle the monthly POS rental fee via the above-mentioned payment options, Merchant Sales shall deduct the monthly rental fee from the security deposit.
We agree to immediately pay any amount deducted from the security deposit as such should remain intact for the period that the POS Rental Arrangement is in place. A written
notification will be sent to us stipulating the required payment amount to be settled to ensure continuous utilization of the POS terminal.

5. We agree that the remaining POS rental monthly dues not covered by the security deposit will be due and demandable and shall be deducted from our settlement account.

6. Failure to settle the monthly POS rental fee and the security deposit ninety (90) days upon receipt of the written notification will compel Merchant Sales to pullout the POS terminal
within seven (7) banking days after the security deposit has been exhausted.

Merchant ID/s √Authorized Signature over Printed Name Date

MSD-20 Rev. Dec 2009