LANDBANK OF THE PHILIPPINES

Exhibit 2
Branch Pinamalayan (Mindoro) Branch

LANDBANK CASH CARD/PREPAID CARD ENROLLMENT FORM

Date: Mar 10, 2021
Please check the type of card being enrolled:

Purchaser's Information
Purchaser's Name: With existing account with LBP
RUTH LAGROSA TARATARA 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:
RUTH LAGROSA TARATARA Female
Marital Status:
Single
Permanent Address: Zip Code:
MUNTINLUPA, BULI, 5208
PINAMALAYAN, ORIENTAL MINDORO
Present Address: Zip Code:
MUNTINLUPA, BULI, 5208
PINAMALAYAN, ORIENTAL MINDORO
Place of Birth: Date of Birth: Nationality: Mother's Maiden Name:
Buli Pinamalayan Oriental Mindoro Jun 26, 2001 PH Norma Lagrosa Taratara

Type of ID Presented: ID Number Presented: Profession: TIN: Source of Fund:

Student ID 190627 Student N/A Other - Stipend

Name of Employer/Company/Business/School: Contact Number/s: Email Address: Gross Salary:

EMA EMITS College Philippines 9127151920 taratararuth967@gmail.com P30,000 and below

Cardholder's Information
Cardholder's Name: Contact Number/s: Date of Birth:
RUTH LAGROSA TARATARA 9127151920 Jun 26, 2001

Permanent Address: Zip Code: Relationship with:

MUNTINLUPA, BULI 5208 the Purchaser
PINAMALAYAN, ORIENTAL MINDORO
Present Address: Zip Code: N/A
MUNTINLUPA, BULI 5208
PINAMALAYAN, ORIENTAL MINDORO
Name to Appear on the Card (maximum of 22 characters):

Initial Load Amount of Fee/Charges to be paid:

(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:

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/BSO Branch Head

Date/Time: ___________________ Date: ___________________ Date: ___________________
for Branches without BOO
Validation Print (if paid through cash):

CASH CARD/PREPAID CARD/PIN MAILER CLAIM STUB

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

Prepaid Card Released by: PIN Haller Released by: Approved for Release: Card/PIN Mailer Recieved by:

Card Custodian PIN Mailer Custodian Branch Head/BOO/BSO Signature Over Printed Name
of Purchaser/Cardholder
Date/Time: ___________________ Date/Time: ___________________
Reminder/s:
- 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 debted from deposit account):
TES-01-17-04030-2019-02299-RUTH LAGROSA TARATARA