CUSTOMER INFORMATION FORM (CIF)

FOR INDIVIDUAL

CUSTOMER INFORMATION
ACCOUNT NUMBER ✔ Please update mobile number and/or e-mail address of my SB Online Account SBOL REF. NO.

0000021302145 SB Online User ID christine1993

NAME
Calo Christine Cinco
(Last Name) (First Name) (Middle Name) (Suffix)

DATE OF BIRTH (MM/DD/YYYY) PLACE OF BIRTH GENDER

06/03/1993 Brgy.Roxas Mainint, SDN Male ✔ Female
NATIONALITY Citizen With Standing Instruction to transfer With SPA issued to a person with U.S.
funds to account maintained in the US? Address; or "in care of" or "hold mail" address?
✔ Resident
Filipino Yes No Yes ✔ No
Non-Resident
PRESENT HOME ADDRESS
Brgy. Cansaga Purok 5 Consolacion Cebu City
(Floor / Number, Street, Barangay / Subdivision / Municipality, City / Province, Postal Code)
PERMANENT HOME ADDRESS (For U.S. ,Japanese or Foreign National, address in foreign country is mandatory) PHONE NO. U.S. TIN
Brgy. Cansaga Purok 5 Consolacion Cebu City
(Floor / Number, Street, Barangay / Subdivision / Municipality, City / Province, Postal Code)
TIN / SSS / GSIS #, if any PRIMARY PHONE NO. (LANDLINE) MOBILE NO. E-MAIL ADDRESS
313-228-345-000 0325649328 09562714899 calo.christine@yahoo.com
NAME OF EMPLOYER OCCUPATION / POSITION YEARS IN WORK
Synchrony Global Financial Inc. Philippines Customer Service Associates 1year and 11 mnths
NATURE OF WORK OR EMPLOYMENT SOURCE OF FUNDS
Agriculture Education Manufacturing Professional Practice Business Remittance Inheritance
Brokerage Financial Institution Medical Service Others
✔ Salary Interest Income from Investment Pension
Insurance Marine Others
Construction BPO Call Center Agents Commission Sale of Investment/Property

ACCOUNT/S MAINTAINED WITH OTHER BANKS COMPANY/IES WITH RELATED INTEREST FEATURES/SERVICES TO BE AVAILED SECURITY BANK
PRODUCT APPLICATION
NAME OF BANK ACCOUNT TYPE (e.g. as Director, Officer, Stockholder, etc.) Fund Transfer Facilities Remittance
Credit Card
1. 1. Check Protector Others
Home Loan
2. 2. Maximizer
Auto Loan
3. Scheduler
3. Personal Loan
Please use separate sheet if necessary. Please use separate sheet if necessary. MobileBanker / TeleBanker Small Business Loan

DEPOSITOR’S AGREEMENT

By signing this form, I hereby certify that the information I provided is true and accurate to the best of my knowledge and that the documents submitted are authentic. I shall notify
SBC in writing of any change in the information supplied in this form. I have read, understood and agreed to be bound by the terms and conditions governing all products, services
or facilities rendered /to be rendered by Security Bank Corporation (SBC) including the Bank’s applicable service and maintenance fees. I further acknowledge that said terms,
conditions and amount of applicable fees were provided to me and/or are available for my viewing at the Bank’s website @www.securitybank.com which I commit to visit from time
to time. All accounts opened under my name shall be recognized in the Account Details Form (ADF) or Signing Instruction Form (SIF) which shall be used by the Bank as basis for
my banking transactions. Subject to remain in effect for five (5) years after account closure, I hereby give consent for SBC to share and process any information relating to my
account/s to any member of the SBC Group (SBC and its affiliates and subsidiaries reported as part of SBC’s conglomerate map/group structure as defined under BSP Circular
749) and Bancassurance companies or their authorized Service Providers and representatives, for purposes of cross-selling products and services, profiling and credit evaluation/
reference checks, audit and account balance confirmation and allow them to contact us for this purpose (i.e. by e-mail, telephone, text, etc.), or in case of audit where our account
is chosen as a sample for account balance confirmation.

I hereby grant full permission to the SBC group to access all information relating to my accounts, and to make the corresponding required reports in compliance with Foreign Tax
Compliance Act (FATCA) due diligence rule, other inter-governmental agreements and other applicable laws, rules and regulations as may be passed from time to time.

✔ No, I do not agree to have my account/s used for purposes of cross-selling products and services, profiling and credit evaluation/reference checks, audit and account
balance confirmation.

Christine Cinco Calo 09/24/2020

Signature Over Printed Name / Date

Note: Please send this form together with 2 valid photo-bearing IDs (for payroll account, 1 government ID and
1 company ID).

BR-1301-0320-IND (PRINTABLE)

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substitution, modification, storage, uploading, downloading, communication, making available to the public, or broadcasting of this material without the consent and knowledge of Security Bank Corporation
is prohibited and is punishable by a fine and/or imprisonment under Republic Act No. 8792, otherwise known as the Electronic Commerce Act.