Enrollment of Other Person's Account

Confirmation Date & Time: Tuesday, Dec 31 2019; 06:06:07 AM (GMT +8)
Confirmation Number: 1577743567861
RM Number: 00000012753449
Account Name: Shamea Kaye Mcatangay Hilario
Account Number: 8439439212
Relationship: Child
Purpose: Family Support

Reminder
By signing below, I hereby:
• Authorize the Bank to process the enrollment;
• Re-affirm my acceptance of the terms and conditions covering the funds transfer facility;
• Acknowledge that the account will be available in the funds transfer facility of BPI Online
and BPI Mobile App, as well as the other electronic channels of the Bank, if applicable.

After signing, scan and send the enrollment form via email.
Email the scanned copy of the signed form to:
onlinebanking-enrollment@bpi.com.ph
Using the subject: 'Enrollment Request-Third Party Accounts'

Name: ____________________ Signature: ____________________

Please affix your specimen signatures on the spaces provided below.