ACCOUNT DETAILS FORM (SOLE PROPRIETORSHIP/BUSINESS)

ACCOUNT NO.
The Account Details Form (ADF) shall be accomplished on a per account basis. A new ADF must be executed for each succeeding
account opening. For Corporations, a letter of authorization, signed by the signatories authorized per Corporate Secretary’s
Certificate may be submitted instead of a new ADF.

New / Additional Account Updating of Information / Signatories Reactivation of Account

Sole Proprietorship Joint (OR) Joint (AND) Business

ACCOUNT NAME

(Doing Business Under / ITF / BY)

PURPOSE OF ACCOUNT OPENING OR REACTIVATION OF ACCOUNT

PRODUCT NAME ADDITIONAL FACILITIES

Easy Build-up Savings FCDU (USD/3rd CCY ___ ) SB Online DigiBanker

All Access SSS Pensioner ATM Others __________________ Telebanker

CUSTOMER RECEIVED
Debit MasterCard PIN Mailer Passbook Checkbook Others _____________________

DEBIT MASTERCARD NUMBER PASSBOOK SERIAL NUMBER CHECKBOOK SERIES NUMBER

SIGNATORY REQUIREMENT [FOR JOINT (AND) & BUSINESS ACCOUNTS] CONDITIONS

Any 2 Others ______________________________________________
By affixing my/our specimen signature(s), I/we hereby authorize Security Bank Corporation to disburse funds as well as honor other
related banking transactions on the basis hereof, in relation to my/our account. I/we acknowledge that I/we specifically requested
the bank to facilitate the specific instruction I/we ticked-off above. I/we further undertake to indemnify SBC, should any claim, of
whatsoever nature arise or results against SBC in connection with the above request. I/we declare under the penalties of perjury
that my/our co-depositor/s is/are still living. I/we likewise hereby acknowledge receipt of the document(s) ticked-off above (Checkbook,
Passbook, Debit MasterCard, PIN Mailer, Others) and agree to be bound by the appropriate Terms and Conditions governing the
operations of my/our account, as well as the Terms and Conditions for products, facilities, services, and channels, any subsequent
amendments thereto.

Name Signature BBN

1.

2.

3.

4.

5.

6.

For Bank's Use Only

ACCEPTABLE SHORT NAMES (please indicate below) SUPPORTED BY THE ADDITIONAL REMARKS
DOCUMENTS BELOW (as applicable)

Deed of Undertaking

Secretary's Certificate

Others

DOCUMENTS VERIFIED AGAINST ORIGINAL BY SIGNATURE TAKEN / AUTHORIZED BY APPROVED BY BRANCH CODE

Signature Over Printed Name / Date Signature Over Printed Name / Date Signature Over Printed Name / Date

BR-1401-0820-ADF (PRINTABLE)
This form is a proprietary product of Security Bank Corporation intended for its sole use. Any unauthorized review. alteration, amendment, use, disclosure, distribution, importation, removal, substitution,
modification, storage, uploading, downloading, communication, making available to the public, or broadcasting of this material without the consent and knowledge of Security Bank Corporation is prohibited
and is punishable by a fine and/or imprisonment under Republic Act No. 8792, otherwise known as the Electronic Commerce Act.