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August 2016 Version

If you and your Secondary/Supplementary accountholders wish to update your personal information with us, kindly fill out the applicable fields in this
form. Please fill out one sheet per Primary or Secondary/Supplementary accountholder. Once done, kindly sign and email the form to using your registered email address in our records, together with one (1) photo-bearing valid ID with identification number or
date of birth and your supporting documents.

Please be advised that your request can only be processed if you provide your bank account, credit card and/or loan number together with a clear
scanned copy of your valid ID and supporting documents. Also, requests sent via an email address other than from your email address on record will
not be processed.

For a list of acceptable IDs and supporting documents, please refer to the third (3rd) page of this form.

Type of account with Citi:

Bank Cards/Loans Bank and Cards/Loans Account/Card No. ______________________________

(pls specify one )
Bank Account/Card Account Type Primary Secondary/Supplementary

Relation to Primary (if Secondary/Supplementary) ______________________________

Title Mr. Ms. Mrs. Civil Status Single Married Others, pls specify ____________

First Name ____________________________________

Middle Name ____________________________________

Last Name ____________________________________

Mothers Maiden Name ___________________________________

Date of Birth __________________________ Nationality ___________________________

Country of Birth _______________________ Town/City of Birth _____________________

Employer/Business Name _______________________ Nature of Self-Employment/Business _________________________

Occupation/Nature of Work ______________________ Position/Job Title ___________________________

Tax Identification No. (TIN)_______________________ SSS/GSIS/UMID No. __________________________

ID submitted with this form (e.g. SSS/GSIS/Passport) __________________________ ID No. _______________ Expiry Date ____________

Source of Funds Salary/Employment Investment Rental Income Personal Savings Others, pls specify __________
Sale of Property Pension Inheritance Business Income (GIS or DTI registered)

*If you wish to update your address, contact number and/or email address, please logon to and click
My Contact Details under Services or call CitiPhone at 995 9999 (Metro Manila) or 234 9999 (for Metro Cebu).

Accountholders Confirmation:

I declare the information given by me in this form to be true and correct and request Citi to update the relevant information in your records. I
further agree to notify Citi in writing in case of any change in my personal information.

I likewise acknowledge receipt of and agree to be bound by the terms and conditions governing each of my accounts or investments with
Citibank, N.A. Philippine Branch, including the terms and conditions found at the back of this form.

Submitted by: ______________________________

Signature over Printed Name
and Date submitted
For Bank Use Only:

Processed by: Approved by:

________________________ ________________________
Signature over Printed Name Signature over Printed Name
Transfer and Processing of Information

I authorize the Bank to verify and obtain copies of all information and submitted documents from the Bureau of Internal Revenue (BIR) and other
appropriate sources including my employer/s and/or my accountant/s (Income Sources). I also authorize each of the Income Sources to disclose any
information relevant to the said verification and give copies of my Income Documents to the Bank. I waive any rights on the confidentiality of my income
information as required by BSP Circular 622, as amended by BSP Circular 855. As required under Republic Act 10173 and other applicable laws and
regulations, I authorize and give consent for the following:

For the Bank to allow its offices, branches, subsidiaries, affiliates, agents, representatives, and third parties selected by the Bank or any of them and
certain companies (collectively referred to as Authorized Third Parties) to offer through mail/e-mail/fax/SMS, by telephone, or by any other means of
communication, including social media and/or to provide products and services to me;

For the Bank to disclose and share my name and Card and/or Ready Credit/Personal Loan account information (Account Information) to/with the
Credit Information Corporation, any credit bureau, credit information service provider/s, lending institution/s, financial institution/s, banking and credit
industry association/s, and service providers of such entities (collectively referred to as Credit Institutions), and in the event of delinquency, to further
report and/or include my name and Account Information in the credit reference lists of such Credit Institutions;

For the Bank, its Authorized Third Parties, and the Banks/Authorized Third Parties officers, directors, employees, agents, professional advisers and
third party service providers, to collect and verify any information about me from any third party for any of the purposes specified in this section;

For the Bank, its Authorized Third Parties, and the Banks/Authorized Third Parties officers, directors, employees, agents, professional advisers and
third party service providers, to collect, process, store, record, organize, update, modify, block, erase and destroy (collectively referred to as process)
my personal information (Personal Information) and/or Account Information with the Bank and any information the Bank obtains from third parties,
including my account information with other financial or non-financial institutions, for any of the purposes specified in this section;

For the Bank to transfer, disclose, use and process my Personal and Account Information (including information that the Bank obtains from third
parties, such as Credit Institutions and other financial or non-financial institutions), to, between and among its Authorized Third Parties (now referred to
as the Receiving and Disclosing Parties), Credit Institutions, other financial or non-financial institutions, or the outsourced service providers of such
entities, wherever situated, or a Government Requirement, for any lawful purpose such as verification of my identity in accordance with the Banks
prescribed verification procedure, business development, data processing, analysis and management, surveys, product and service offers, account
servicing, including rewards redemption and fulfilment, marketing activities, risk management purposes, collections purposes and reporting, use in
employment checking (for financial institutions), and compliance with laws, regulations and policies on anti-money laundering, sanctions and/or the US
Foreign Account Tax Compliance Act (FATCA), including withholding for purposes of the FATCA. In addition to the above, the Bank or any of the
Receiving and Disclosing Parties may disclose any information as may be required by any Government Requirement, and for compliance with any
Government Requirement, or as required by or for the purposes of any audit or investigation of any authority. Government Requirement means any
applicable law or regulation, legal, governmental or regulatory authority, or agreement entered into by the Bank and any governmental authority or
between two or more governmental authorities (such law, regulation or authority may be domestic or foreign).

Where the Bank is a user, member or subscriber of the information sharing services or activities of any Credit Institution:

a. For the Bank to transfer and disclose to any Credit Institution and the Banks/Credit Institutions outsourced service providers, and
b. For the Credit Institution to transfer and disclose to fellow users, members or subscribers, whether financial or non-financial institution,

any of my Personal and Account Information with the Bank. The information that may be disclosed includes basic credit data and negative
information under Republic Act No. 9510, other information that may be required by the Credit Information Corporation, Personal Information,
demographic information, monthly account information, profile, performance and history.

The information that may be transferred and processed under this section also includes Confidential Information, which refers to information relating to me
or my representatives received by the Bank, its Authorized Third Parties and the Banks/Authorized Third Parties respective representatives in the course
of providing accounts and services to me. This includes my Personal Information, Account details, transactional information, and any other information that
I have designated as confidential at the time of disclosure or that an ordinary person would consider to be confidential or proprietary.

The above consent applies for the duration of and even after the closure or cancellation of my account/s. My consent will be effective despite any
applicable nondisclosure agreement and I acknowledge that information relating to me and my account/s, including Confidential Information, may be
transferred to jurisdictions which do not have strict data protection or data privacy laws.

I declare that I have provided any notices, consents and waivers necessary to permit the Bank, its Authorized Third Parties, and the Banks/Authorized
Third Parties third party service providers and payment infrastructure providers to carry out the actions described in this provision.

If I have existing unsecured credit facilities with the Bank, I agree and consent for the Bank to review and adjust the credit limits of the said facilities in the
Banks absolute discretion in accordance with its credit policies.

I agree to hold the Bank free and harmless from any liability that may arise from the processing and use of my Personal and Account Information, and
other information pertaining to my accounts with other financial and non-financial institutions.

Limitations to the Banks Liability

All obligations hereunder are payable solely at Citibank, N.A. Philippine Branch, subject to the laws of the Philippines (including any governmental actions,
orders, decrees and regulations).
Acceptable IDs/Supporting Documents

List of acceptable IDs

Philippine and Foreign Government-issued passport

Drivers license
Alien Certificate of Registration or Immigration Certificate of Registration or any similar visa certificate issued by a recognized
foreign country
Social Security System (SSS) photo card type
Tax Identification Number (TIN) photo card type
Government Security Insurance System (GSIS) e-Card
Unified Multipurpose ID (UMID)
Special Resident Retirees Visa (SRRV)
Senior citizen ID photo card type
Photo ID's issued by a government owned or controlled corporation, department, agency or instrumentality of the national
government including Armed Forces, Philippine National Police, Department of Foreign Affairs, Executive, Legislative, Judiciary,
Senate, Philippine Overseas and Employment Agency, Home Development Mutual Fund, Civil Service Commission, Professional
Regulations Commission, Philippine Postal Service, Philippine Veterans Affairs Office. This includes photo ID issued by
Philhealth to its members.
ID issued by the US Embassy and Asian Development Bank to its employees.
For students of minor age, School ID (with photo and signature of Principal or Head of School) along with any of the following:
Certified Birth certificate, library ID or membership IDs duly issued by any association or organization within the college or
university and signed by the pertinent authority issuing the ID.
Voters Identification issued by Commission on Election photo card
Overseas Workers Welfare Administration (OWWA) ID
Philippine Stock Exchange (PSE) ID

Accepted supporting documents for the following request:

A. Name Change/Correction (any of the following)

Birth Certificate
Marriage Certificate (if Single to Married)
Certified true copy of Divorce Papers/Certificate of Annulment or Legal Separation (if Married to Single)
Passport or any valid government-issued ID

B. Nature of Work/Name of Employer (any of the following)

Company ID
Certificate of Employment (COE) issued in the last 60 days
HR Endorsement
If self-employed: Business registration

C. Source of Funds (any of the following)

Certificate of Employment (COE)
SEC Registration
DTI Registration
Latest payslip
Latest ITR and/or AFS, W2
Employment Contract
Business-related documents reflecting clients name (e.g. Business registration)

D. Nationality (any of the following)

Any valid government IDs reflecting clients nationality