REPUBLIC OF THE PHILIPINES )

) SS

AFFIDAVIT OF ADMISSION AFFIDAVIT

I, ______________________ of legal age, Filipino, (single, married), with address at

______________________________________, and ___________________________, of legal age, Filipino,
(single, married), with address at _____________________________________, after being duly sworn in
accordance with law, do hereby depose and say that:

1. That I opened a Savings/Checking/AIOCA/ISA/Time Deposit account at the _________ Branch of Security

Bank Corporation (the “Bank”) under SA/CA/ISA/TD No. ____________________;
2. That I/We I submitted to the bank a valid Valid Identification Document ______________ issued by
____________ on ____________;
3. That in the said Identification Document, ________________________(signature of client per ID
presented) appears to be my signature;
4. That iin addition to the signature in item#3appearing in said Identification Document, I hereby admits and
recognize the following additional signature (s) as my own signature to signify my consent or conformity to
any intended transaction with SBC-___________________ Branch:
:

_______________________________
(Signature over printed name)

________________________________
(Signature over printed name)

5. That I am executing this Affidavit in order to request from the Bank the inclusion of the above signatures
as part of my Specimen Signature Card in the mentioned account maintained with the bankBank;
6. As such, I hereby certify that the signatures alleged above are my signatures and any document found
bearing either or both of said signatures are binding and enforceable against me;
7. That I and my surety I do hereby undertake, jointly and severally to hold the Bank free and harmless from
any liability, suit, claim or action that may be filed or instituted against it by any person, including the
undersigned, and to indemnify the Bank for any loss or damage that it may suffer or sustain by reason of
the recognition/ admittance of the signatures in item#4, by any person or by virtue of any transaction
entered into by the undersigned with respect to my/our deposit maintained in the bank.
8. I am executing this Affidavit to attest to the truth of the foregoing, for whatever legal purpose it may serve.

9. FURTHER AFFIANT SAYETH NAUGHT.

WITNESS MY/OUR HAND this _______ day of ____________ in __________.

(Signature over printed name)

AFFIANT

Signed in the Presence of

 ______________________________ ______________________________

SUBISCRIBED AND SWORN TO BEFORE ME this ____ day of ______________, 20__, at

_______________, Affiant exhibited to me his/her Valid Identification Document/CTC No.
_________________________, issued on ___________________________ at _____________________.

NOTARY PUBLIC

Doc No. ________;

Page No. _______;
Book No. _______;
Series of _______.