6/20/2019 COL Financial - Philippines

Date June 21, 2019

Operations Dept
COL FINANCIAL GROUP, INC.
2401-B East Tower, Philippine Stock Exchange Centre, Exchange Road,
Ortigas Center, Pasig City 1605 Philippines
Tel. No. 6-515-888 | Fax No. 687-5459 | Email: stockcerts@colfinancial.com

REQUEST FOR UPDATE IN BANK DETAILS

COL Account Name: BENLOT, MARK ANTHONY L.

COL Account # 29000637

I/We, hereby request COL FINANCIALto update my/our bank details to the following:

Bank Account Number*: 200030302817

Bank Code: EW
Bank Branch: Archbishop Reyes Ave Branch
Unit No.: Grand Cenia,
Street / Village: Archbishop Reyes Ave
City / Country: Cebu City, Philippines

Please make the necessary changes to update my/our profile.

____________________________________ ____________________________________
Primary Account Holder's Signature Secondary Account Holder's Signature
(Needed for Joint Accounts)
(*Bank account name/s should match your registered COL Account Name/s to facilitate bank deposits. Banks may reject deposits if they
find inconsistencies with listed names, forcing COL to release withdrawals through Check Pick Ups fromour Business Center.)

Please print and sign this form then submit the printout (or scanned copy) to: "COL Operations Group" via
a) email: stockcerts@colfinancial.com or
b) Fax: (632)687-5459 or
c) Snail Mail: 2401-B East Tower, Philippine Stock Exchange Centre, Exchange Road, Ortigas Center, Pasig City 1605 Philippines

(Update requests in Bank Account details may take from 48 up to 72 hours to verify and amend.)

(FOR COL FINANCIAL USE ONLY, PLEASE DO NOT WRITE BELOW THIS LINE)
Received by: ___________________________ Date: ________________ Time:______________
Verified by: ____________________________ Date Verified: _____________________________

PSE Trading Participant; SIPF and SCCP Member

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