Deposit/ Product Record Form

DEVELOPMENT BANK OF THE PHILIPPINES Individual & Joint Accounts

Name

/ / /Last Name /
First Name Middle Name Suffix (e.g. Jr, Sr) Nickname

DEPOSIT/PRODUCT DETAILS
Product Type Account Number Date Opened
☐ Savings ☐ Special Savings
/ / - -
☐ Current ☐ Prepaid Card M M D D Y Y Y Y

☐ Time Deposit ☐ EC Card Name to appear on ATM Card

☐ Option Savings ☐ Others: ______________________
N/A
Account Type Currency DBP Prepaid Card Number (For Bank use only)
/ Single
☐ / Peso
☐
☐ Joint ☐ AND ☐ OR ☐ Dollar N/A
☐ ITF ☐ Others: _______________________
For Savings Account For Current Account Preferred Mailing Address Initial Deposit Minimum Balance Required
☐/ ATM only ☐ With ATM ☐ Present
☐ Passbook only ☐ Without ATM ☐ Permanent P100.00 P100.00
☐ ATM and Passbook ☐ Employer Office/ Business
Source of Funds Tax Status Purpose for Opening an Account
/ Salary
☐ ☐ Inheritance
/ Taxable
☐
☐ Business ☐ Pension/ Remittance ☐ Tax Exempt
☐ Investment Proceeds ☐ Commission/ Interest FOR PAYROLL
☐ Loan Proceeds ☐ Others: _______________________

OTHER ACCOUNTS MAINTAINED WITH DBP, IF ANY

/ DBP Branch/es Product Type
1.___________________________ ☐ Savings ☐ Current ☐ Time Deposit ☐ Option Savings ☐ Special Savings ☐ Others: __________________

2.___________________________ ☐ Savings ☐ Current ☐ Time Deposit ☐ Option Savings ☐ Special Savings ☐ Others: _________________

3.___________________________ ☐ Savings ☐ Current ☐ Time Deposit ☐ Option Savings ☐ Special Savings ☐ Others: _________________

NAME AND CIF OF CO-DEPOSITOR/S

Name CIF Number

First Name Middle Name Last Name Suffix (e.g. Jr, Sr)
Name N/A CIF Number

First Name Middle Name Last Name Suffix (e.g. Jr, Sr)

I hereby certify that the above information is true and correct to the best of my knowledge and confirm that
I fully understand and agree to be governed by the rules and regulations of the Bank. / Signature over Printed Name/ Date Signed
FOR BANK USE
CIF Number: Date Updated Next Review Date Risk rating / Low ☐ Normal ☐ High as of __________
☐
Customer is included in the Bank’s watchlist:
0 6 2 5 / /2024 / No ☐ Yes ☐ OFAC/FATF
☐ ☐ PEP as of ________

Customer Contact: ☐ Walk-in Authenticated by Approved by

/ Referred
☐
DEPED
Name & ID #: _____________
Relationship: ______________ / CSA MA. LAILA A. PEREZ/ BRANCH CASHIER
Signature over Printed Name/ Date Signature over Printed Name/ Date

BB 0816.r3.2019
“This is to acknowledge the receipt of copy of the Rules and Regulations governing the deposit account and any supplemental Rules and Regulations for all
applicable products, facilities or services by the Development Bank of the Philippines (DBP), its subsidiaries or affiliates, including but not limited to electronic
banking and other banking product and services. I, in my own capacity or for and on behalf of the entity, hereby read, fully understood, agree and abide with
these Rules and Regulations, and further agree that my/the entity’s continued use of the Bank’s products and services means acceptance of any subsequent
update or revision/s of the foregoing Rules and Regulations.”

/ Signature over Printed Name/ Date Signed