A7 - Foreign AccountTax Compliance Act (FATCA) Due Diligence Form

CIF Number
(for internal use)

I. ON YOUR OBLIGATION TO PAY TAXES TO THE U.S. IRS

I am a U.S. Citizen
If ‘Yes’, provide your U.S. SS / TIN Number I hold permanent
resident status in the U.S.
(If ‘Yes’, you must provide a U.S.
address in the next section - ‘US
Indicia’)

I meet the ‘Substantial Presence Test’ as defined by U.S. IRS

II. ON YOUR U.S. INDICIA

I have a U.S. Telephone Number If ‘Yes’, provide your U.S. Telephone Number

I have a U.S. Address If ‘Yes’, provide your U.S. Address and / or P.O. Box Number
Unit No. Building / No. Block. Street Subdivision / District / Town

City State ZIP P.O. Box Number

I have standing instructions for regular transfer of funds to an account in the U.S I have granted a Power of Attorney to a person with a U.S. address

CUSTOMER UNDERTAKING Signature over Printed Name

By signing, I hereby certify that the information in this form is true and correct Date Signed
to the best of my knowledge. I undertake to advise BDO Group and provide (mm / dd / yyyy)
documentation for any changes to the above information.
/ /

BDO Unibank, Inc. is regulated by the Bangko Sentral ng Pilipinas.

Tel. No.: (02) 8708-7087; Email: consumeraffairs@bsp.gov.ph. REVISED AS OF MAY 2022
The BDO, BDO Unibank, and other BDO-related trademarks are owned by BDO Unibank, Inc.