Monetary Forms Updated

CLASS B
LAND BANK OF THE PHILIPPINES

Mandaue Branch
weAccess ENROLLMENT AND MAINTENANCE AGREEMENT FORM
INSTITUTION PROFILE
Name of Institution Short Name
BARANGAY CASILI CASILI
Address ZIP Code Country

CASILI MANDAUE CITY CEBU 6014 PHILIPPINES
No. Street Barangay/District Municipality/City Province
Contact Number Fax Number Tax Identification Number (TIN) Date of Incorporation
349-2770 640 ### 407 - 159 - 000 - -
Area Code Telephone Number Ext. Area Code Telephone Number M M D D Y Y Y Y
BIR Registered Name Institution's Email Address1/ Client Type2/

ANTONIETTA L. SE ÑERES casilimandaue2024@gmail.com LGU
SUBSIDIARIES
INSTRUCTIONS INSTITUTION NAME TAX IDENTIFICATION NUMBER (TIN)
- - -
- - -
THIRD PARTY ACCOUNTS

As Fund Transfer Destination
INSTRUCTIONS ACCOUNT TAG3/ ACCOUNT NUMBER
- -
- -
As Auto-Debiting Source
INSTRUCTIONS ACCOUNT TAG3/ ACCOUNT NUMBER
- -
- -
BILLS PAYMENT
INSTRUCTIONS MERCHANT NAME REFERENCE NUMBER
CHARGES (if any)

Total Number of weAcess USB/flash disk: Please put N/A if Not Applicable. Total Billing:
Cost of weAccess USB/flash disk in excess of three (3)
Cost of weAccess USB/flash disk Replacement
Cost of weAccess vToken Application
ACKNOWLEDGMENT
This serves as our application to your LANDBANK weAccess Facility. I/We hereby acknowledge to have read, understood and agreed to be bound by
the Terms and Conditions of the LANDBANK weAccess facility.
antonietta l. seÑeres 3/13/2024

Signature over Printed Name of Authorized Signatory Date
FOR BANK USE

SERVICING BRANCH/EO SYSTEMS IMPLEMENTATION DEPARTMENT
Reviewed by Verified by Approved by Checked by Enrolled by Date
Distribution Copy 1 - SID Copy 2 - Institutional Client Copy 3 - Depository Branch
Notes: (1) Please write "Not Applicable" or "N/A" for fields with no applicable data and/or "Nothing Follows" immediately after the last item.
(2) Please use additional sheets, if necessary.
1/
The designated email address where notices from the weAccess Facility shall be sent.
2/
e.g. GOCC, NGA, LGU, Private Corporation, Partnership, Cooperative, SME, Educational and Health Institution, Development Partnet, Religious and
Charitable Organization, Commercial/Universal Bank, Thrift Bank, Rural Bank, Other Financial Intermediary, NGO/People Organization/Association,
Micro-Enterprise, Sole Proprietorship
CLASS B
3/
The designated account description with a maximum of 15 alphanumeric characters (e.g. Payroll Account).
page 1
CLASS B
ACCOUNT ACCESS PROFILE
INSTRUCTIONS ACCOUNT NUMBER ACCOUNT TAG1/

Add 1332 - 0047 - 82
AUTO CREDITING REQUEST AUTO DEBITING REQUEST

Authorization Rule Amount Range Authorization Rule Amount Range
ATM PAYROLL BILLS PAYMENT

any one
ACCOUNT TAG MANAGEMENT REMITTANCE

FUND TRANSFER CURRENT ACCOUNT SERVICES

Source Account Destination Account Checkbook Reorder
FUND SWEEPING Mother Account Satellite Account
INWARD SWEEP OUTWARD SWEEP

(Group, Scheduled, Manual Inward Sweep Request) (Group, Outward Sweep Request)
REPORTS Downloadable Reports Viewable Reports

Salary Related Reports Adhoc Reports - Bills Payment Gov't. Merchant Reports
ePayments Reports Loan Profile Reports Others
INSTRUCTIONS ACCOUNT NUMBER ACCOUNT TAG1/

- -
AUTO CREDITING REQUEST AUTO DEBITING REQUEST

ATM PAYROLL BILLS PAYMENT

ACCOUNT TAG MANAGEMENT REMITTANCE

FUND TRANSFER CURRENT ACCOUNT SERVICES

Source Account Destination Account Checkbook Reorder
FUND SWEEPING Mother Account Satellite Account
INWARD SWEEP OUTWARD SWEEP

(Group, Scheduled, Manual Inward Sweep Request) (Group, Outward Sweep Request)
REPORTS Downloadable Reports Viewable Reports

Salary Related Reports Adhoc Reports - Bills Payment Gov't. Merchant Reports
ePayments Reports Loan Profile Reports Others
ACKNOWLEDGMENT
Signature over Printed Name of Authorized Signatory Date
(2) Please use additional sheets, if necessary.
1/
The designated account description with a maximum of 15 alphanumeric characters.
CLASS B
page 2
CLASS B

Mandaue Branch

USER PROFILE
Name
First Name Middle Name Last Name
User ID Position/Designation Gender Date of Birth Date of Birth E-mail Address

- -
M M D D Y Y Y Y
vToken ID Contact Number/s Civil Status Tax Identification Number (TIN)

NA Landline Mobile Single Divorced 000 - 000 - 000 - 000
Challenge Questions Married Separated FOR BANK USE ONLY

1. Mother's Complete Maiden Name Widowed Internet Password Mailer ID
2. Name of High School - - -
3. Grandfather's Name
INSTRUCTIONS USER TYPE1/ ACCOUNT NUMBER ACCESS RIGHTS (pls. check applicable modules)
✘ Account Information Fund Transfer Current Account Services

- - ATM Payroll Bills Payment Report
Remittance Fund Management2/ Loan Profile
ACIC File Upload ECNOW Access
Account Information Fund Transfer Current Account Services
- - 1 ✘ ATM Payroll Bills Payment Report
Remittance Fund Management2/ ✘ Loan Profile
ACKNOWLEDGMENT
CLASS B
Signature over Printed Name of User Signature over Printed Name of Authorized Signatory Date
FOR BANK USE


(2) User ID must be composed of 6-8 alphanumeric characters, letters using upper cases only. The number zero should be written as "Ø"
to differentiate from the letter "O".
(3) Vtoken ID must be composed of 8 alphanumeric characters. The number zero should be written as "Ø" to differentiate from the letter "O".
1/
Authority of the designated user.
2/
Fund Management includes Auto Crediting, Auto Debiting and Fund Sweeping Modules. page 2
CLASS B

Mandaue Branch

USER PROFILE
Name ANTONIETTA LISONDRA SE ÑERES
First Name Middle Name Last Name

PUROK IWAY, CASILI, MANDAUE CITY, CEBU 6014 PHILIPPINES
User ID Position/Designation Gender Date of Birth Date of Birth E-mail Address

Barangay Treasurer Female 08 - 27 - 1965 casilimandaue2024@gmail.com
M M D D Y Y Y Y
vToken ID Contact Number/s Civil Status Tax Identification Number (TIN)

NA Landline
349-2770
Mobile
9334978168 Single Divorced 640 - 407 - 159 - 000
Challenge Questions Married Separated FOR BANK USE ONLY

1. Mother's Complete Maiden Name Pacita Abriol Widowed Internet Password Mailer ID
2. Name of High School University of Cebu - - -
3. Grandfather's Name Sabino Lisondra
✘ Account Information Fund Transfer Current Account Services

- - 1 ✘ ATM Payroll Bills Payment Report
Remittance Fund Management2/ ✘ Loan Profile
CLASS B
ACKNOWLEDGMENT
Signature over Printed Name of User Signature over Printed Name of Authorized Signatory Date
FOR BANK USE


(2) User ID must be composed of 6-8 alphanumeric characters, letters using upper cases only. The number zero should be written as "Ø"
to differentiate from the letter "O".
(3) Vtoken ID must be composed of 8 alphanumeric characters. The number zero should be written as "Ø" to differentiate from the letter "O".
1/
Authority of the designated user.
2/
Fund Management includes Auto Crediting, Auto Debiting and Fund Sweeping Modules. page 2

Monetary Forms Updated

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CLASS B

LAND BANK OF THE PHILIPPINES

weAccess ENROLLMENT AND MAINTENANCE AGREEMENT FORM

Address ZIP Code Country

BIR Registered Name Institution's Email Address1/ Client Type2/

THIRD PARTY ACCOUNTS

CHARGES (if any)

antonietta l. seÑeres 3/13/2024

FOR BANK USE

Distribution Copy 1 - SID Copy 2 - Institutional Client Copy 3 - Depository Branch

ACCOUNT ACCESS PROFILE

INSTRUCTIONS ACCOUNT NUMBER ACCOUNT TAG1/

AUTO CREDITING REQUEST AUTO DEBITING REQUEST

ATM PAYROLL BILLS PAYMENT

ACCOUNT TAG MANAGEMENT REMITTANCE

FUND TRANSFER CURRENT ACCOUNT SERVICES

FUND SWEEPING Mother Account Satellite Account

INWARD SWEEP OUTWARD SWEEP

REPORTS Downloadable Reports Viewable Reports

INSTRUCTIONS ACCOUNT NUMBER ACCOUNT TAG1/

AUTO CREDITING REQUEST AUTO DEBITING REQUEST

ATM PAYROLL BILLS PAYMENT

ACCOUNT TAG MANAGEMENT REMITTANCE

FUND TRANSFER CURRENT ACCOUNT SERVICES

FUND SWEEPING Mother Account Satellite Account

INWARD SWEEP OUTWARD SWEEP

REPORTS Downloadable Reports Viewable Reports

Signature over Printed Name of Authorized Signatory Date

LAND BANK OF THE PHILIPPINES

Name of Institution Short Name

Address ZIP Code Country

No. Street Barangay/District Municipality/City Province

User ID Position/Designation Gender Date of Birth Date of Birth E-mail Address

vToken ID Contact Number/s Civil Status Tax Identification Number (TIN)

Challenge Questions Married Separated FOR BANK USE ONLY

✘ Account Information Fund Transfer Current Account Services

FOR BANK USE

SERVICING BRANCH/EO SYSTEMS IMPLEMENTATION DEPARTMENT

Distribution Copy 1 - SID Copy 2 - Institutional Client Copy 3 - Depository Branch

LAND BANK OF THE PHILIPPINES

Name of Institution Short Name

Address ZIP Code Country

User ID Position/Designation Gender Date of Birth Date of Birth E-mail Address

vToken ID Contact Number/s Civil Status Tax Identification Number (TIN)

Challenge Questions Married Separated FOR BANK USE ONLY

✘ Account Information Fund Transfer Current Account Services

FOR BANK USE

SERVICING BRANCH/EO SYSTEMS IMPLEMENTATION DEPARTMENT

Distribution Copy 1 - SID Copy 2 - Institutional Client Copy 3 - Depository Branch

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