CLASS D

LAND BANK OF THE PHLIPPINES Exhibit 2

Branch

LANDBANK CASH CARD/PREPAID CARD ENROLLMENT FORM

Date: 11/27/2021

Please check the type of card being enrolled:

Cash Card Prepaid Card Individual Institution

Individual Regular (Master Card/Others, pls specify )
Institution Gift Card Master Card/Others, pls specify

Purchaser's Information
Purchaser's Name: With existing account with LBP Yes

PROVINCIAL GOVERNMENT OF BATAAN If yes, pls specify Acct. No/s.:

Cash Card Number/s:
ADDITIONAL INFORMATION FOR WALK-IN INDIVIDUAL PURCHASER, AND CARDHOLDER OF INSTITUTIONAL PURCHASER:
Cardholder's Name Gender:
Ms. FEMALE
Mr.
Mrs.
PAULINE S. BUENSUCESO Marital Status:
SINGLE
Permanent Address: Zip Code:
20 - I CABRITIT ST. MABATANG ABUCAY BATAAN 2114
Present Address: Zip Code: Recent Photo
20 - I CABRITIT ST. MABATANG ABUCAY BATAAN 2114 (optional)
Place of Birth: Date of Birth: Nationality: Mother's Maiden Name:
BALANGA CITY 01/27/2001 PHL PINKY D. SILVA
Type of ID Presented: ID Number Presented/Place of Issuance Profession TIN Source of Fund:

SCHOOL ID 19-00870 N/A N/A SCHOLARSHIP

Name of Employer/Company/Business/School: Contact Number/s: (home/office/mobile) email Address Gross Salary
BATAAN PENINSULA STATE UNIVERSITY 0945-537-7746 ayen027@gmail.com PHP 5,000
Cardholder's Information
Cardholder's Name: Contact Number/s: Date of Birth:
PAULINE S. BUENSUCESO 0945-537-7746 01/27/2001
Permanent Address: Zip Code: Relationship with
20 - I CABRITIT ST. MABATANG ABUCAY BATAAN 2114 the Purchaser:

Present Address: Zip Code:

20 - I CABRITIT ST. MABATANG ABUCAY BATAAN 2114 BENEFACTOR
Name to Appear on the Card (with maximum of 22 characters)
PAULINE SILVA BUENSUCESO
Initial Load Amount of Fees/Charges to be paid:

$ P ₱
(for Prepaid Travel Card) (for Cash Card/Regular Prepaid) (Initial Cost of the Card)

I/We hereby certify that the above information is true and correct:

PAULINE S. BUENSUCESO
Signature Over Printed Name Signature Over Printed Name
of Purchaser/Applicant/Authorized Signatory of Purchaser/Applicant/Authorized Signatory

FOR BANK'S USE ONLY

Processed by: Checked by: Approved by:

Customer Associate/NAC BOO/BSO1 Branch Head

Date/Time: Date: Date:

1
for Branches without BOO
Validation Print (if paid thru cash):

CASH CARD/PREPAID CARD/PIN MAILER CLAIM STUB

Card Number: Card Holder's Name: Purchaser's Name: Date:

Prepaid Card Released by: PIN Mailer Released by: Approved for Release: Card/PIN Mailer Received by:

Card Custodian PIN Mailer Custodian Branch Head/BOO/BSO Signature Over Printed Name
of Purchaser/Cardholder
Date/Time: Date/Time:
Reminders:
- You may claim your Prepaid Card after 7 banking days for Metro Manila Branches, and 15 banking days for Provincial Branches, and a replacement fee shall be collected
- Unclaimed Prepaid Card/PIN Mailer shall be perforated after 120 calendar days (for CCT)/30 calendar days (regular) from issuance/re-issuance
- Please sign your Prepaid Card immediately
Validation Print (if debited from deposit account) :

LANDBANK Cash Card/Prepaid Card Enrollment Form Page 1 of 1

BALANGA – 7,000
MORONG – 6,000
OTHER TOWNS – 5,000