INSTRUCTIONS:

1. Make sure you accomplish all the required fields highlighted in ORANGE.
2. Prepare a cropped rectangular size of your signature so that you can insert signature images.
> Select cell where you want to insert your signature
> Click Insert > Pictures > This Device
> Locate the folder on where you saved your signature, Select the signature image, and click INSERT
3. Input your account number correctly as the program will automatically save a PDF version in your preferred file
> Open the folder where you want the CAOF to be saved
> Right click the address bar and click "Copy Address as text"
Paste where you want the CAOF saved here :
4. Send the PDF version of your digitally signed CAOF and ID following the filename convention to your Corporate
Note: If your computer doesn’t have macros, you can save the file manually under this filename but please complete the CAOF
CAOF (pdf) _C.pdf
ID/s (pdf OR jpg) _I.pdf _I.jpg

Potential reasons of error:

File is already available in the selected path
No path indicated in cell C10
 ature images.

d click INSERT
PDF version in your preferred file location.

me convention to your Corporate HR.

me but please complete the CAOF first!
 EPAYCARD CUSTOMER ACCOUNT OPENING FORM
ACCOUNT DETAILS
DATE (mm/dd/yyyy) 7/9/2021 BRANCH CUSTOMER ID NO.

CLIENT TYPE TYPE OF ACCOUNT ACCOUNT NO.

CARDHOLDER DETAILS
TITLE/SALUTATION NAME GENDER
Last Name, Given Name, Middle Name
MOTHER'S
CIVIL STATUS CITIZENSHIP/NATIONALITY
MAIDEN NAME
Last Name, Given Name, Middle Name

BIRTH DATE (mm/dd/yyyy) PLACE OF BIRTH IF FOREIGNER/ DUAL CITIZEN

*Your Company's HR Officer has automatically enrolled you in receiving SMS Alerts.
MOBILE NUMBER* Kindly inform them if you want to be removed from this service. EMAIL ADDRESS

PRESENT ADDRESS ZIP CODE

(No. / Street / District / Barangay / City / Town / Province)
PERMANENT ADDRESS
(pls edit if not same as Present Address) 0 ZIP CODE 0
(No. / Street / District / Barangay / City / Town / Province)

SOURCE OF FUNDS (Select ONE) SSS NO./ GSIS NO./ TIN

SPECIFY IF OTHERS
CARDHOLDER DETAILS
COMPANY/BUSINESS NAME
(If self-employed) BCM Educational Group Incorporation Manila Br.

BUSINESS ADDRESS ZIP CODE

(No. / Street / District / Barangay / City / Town / Province)

POSITION/DESIGNATION INDUSTRY OF EMPLOYER Education

EMAIL ADDRESS CONTACT NO.

FATCA INFORMATION (SELECT ONE)
DOCUMENTARY REQUIREMENTS
I am NOT a US PERSON

I am a US PERSON (U.S. Citizen OR U.S. Resident OR U.S. Green Card Holder OR U.S. Passport Holder) (1)
I am not a U.S. Person but with U.S. indicators. (1) Certification, Consent, and Waiver AND Form W-9
(2) Certification, Consent, and Waiver AND Form W-9 OR Form W-8,
U.S. Place of Birth (3) Form W-8 BEN AND/OR Non-US passport OR government ID evidencing
U.S. Resident Address / U.S. Mailing Address (including a U.S. post office box) (2) citizenship in another country
(3) Certification, Consent, and Waiver AND Form W-9 OR Form W-8,
U.S. Telephone Number (2) Form W-8 BEN AND/OR Non-US passport OR government ID evidencing
Standing instruction/s to transfer funds to an account maintained in the U.S (2) citizenship in another country OR Certificate of Loss of Nationality of the
US or Form I-407, OR a reasonable explanation of account holder's
Power of Attorney or signatory authority granted to a person with a U.S. Address (2) renunciation of US citizenship OR the reason the account holder did not
obtain US citizenship at birth
“In-care-of” address or “hold mail” address that is the sole address the Foreign Financial Institution has identified for the account holder (2)

CARDHOLDER SPECIMEN SIGNATURE (INSERT IMAGE OF SIGNATURE)

Please provide three specimen signatures.
1) 2) 3)

CARDHOLDER ATTESTATION (INSERT IMAGE OF SIGNATURE)

By my signature herein, I acknowledge that my company’s authorized HR representative has discussed and I have read the UnionBank ePaycard Terms and Conditions found in bit.ly/UBPePaycardTCs
and the Bank's Privacy Policy found in bit.ly/UBPDataPrivacy and I confirm that I fully understand and agree to abide by the terms stipulated and any future amendments thereto. For Checking
Account/s, I agree and undertake not to use cheques, printed or secured from printers, not accredited by your Bank and that I shall be held responsible and liable for any and all losses, damages arising
from the violation of this undertaking.

I confirm that all information I provided are true and correct. I agree to inform Union Bank of the Philippines should there be any changes to my personal data stated above. I consent to the disclosure of
my personal data to UnionBank and other authorized third parties, including subsidiaries and affiliates, of UnionBank to be used for the purpose of processing my application and for the assessment of
my compliance with the necessary requirements needed for this application. I understand that my personal information may also be used for review, audit, and reporting to Bangko Sentral ng Pilipinas
and other regulators.
Ultimately, I hold the Bank free from any liabilities that may arise regarding my account, including those that may arise from the Bank’s imposition of restrictions to or closure of my account that may be
due to incomplete, inaccurate, and/or outdated information provided by me or my company’s HR.

0 7/9/2021
CARDHOLDER
DATE
Signature Over Printed Name

7/9/2021
AUTHENTICATED BY AUTHORIZED HR REPRESENTATIVE
DATE
Signature Over Printed Name
FOR BANK'S USE ONLY (To be filled-out by the Sales Representative)
TYPE OF DEPOSIT CUSTOMER TYPE

EMPLOYER ID RM/ BM/ AO CODE

REMARKS

IDENTIFIED AND SIGNATURE VERIFIED BY DATE

PROCESSED BY DATE

APPROVED BY DATE

APPROVED BY (FOR EDD) DATE

 EPAYCARD CUSTOMER ACCOUNT OPENING FORM
ACCOUNT DETAILS
DATE (mm/dd/yyyy) 7/9/2021 BRANCH CUSTOMER ID NO.

CLIENT TYPE TYPE OF ACCOUNT ACCOUNT NO. 9049302107

CARDHOLDER DETAILS
TITLE/SALUTATION Ms NAME Esparas, Joanne Trinidad GENDER Female
Last Name, Given Name, Middle Name
MOTHER'S
CIVIL STATUS Single MAIDEN NAME Trinidad Oferlia Gutierrez CITIZENSHIP/NATIONALITY Filipino
Last Name, Given Name, Middle Name

BIRTH DATE (mm/dd/yyyy) 09-25-1990 PLACE OF BIRTH 51 Santor Tanauan City Batangas IF FOREIGNER/ DUAL CITIZEN Not Applicable
*Your Company's HR Officer has automatically enrolled you in receiving SMS Alerts.
MOBILE NUMBER* 09754983751 Kindly inform them if you want to be removed from this service. EMAIL ADDRESS [email protected]

PRESENT ADDRESS #51 Santor Tanauan City Batangas ZIP CODE 4232
(No. / Street / District / Barangay / City / Town / Province)
PERMANENT ADDRESS
(pls edit if not same as Present Address) #51 Santor Tanauan City Batangas ZIP CODE 4232
(No. / Street / District / Barangay / City / Town / Province)

SOURCE OF FUNDS (Select ONE) SSS NO./ GSIS NO./ TIN 04-3934944-2

SPECIFY IF OTHERS
CARDHOLDER DETAILS
COMPANY/BUSINESS NAME
(If self-employed) BCM Educational Group Incorporation Manila Br.

BUSINESS ADDRESS ZIP CODE

(No. / Street / District / Barangay / City / Town / Province)

POSITION/DESIGNATION Teacher INDUSTRY OF EMPLOYER Education

EMAIL ADDRESS CONTACT NO.

FATCA INFORMATION (SELECT ONE)
DOCUMENTARY REQUIREMENTS
I am NOT a US PERSON

I am a US PERSON (U.S. Citizen OR U.S. Resident OR U.S. Green Card Holder OR U.S. Passport Holder) (1)
I am not a U.S. Person but with U.S. indicators. (1) Certification, Consent, and Waiver AND Form W-9
(2) Certification, Consent, and Waiver AND Form W-9 OR Form W-8,
U.S. Place of Birth (3) Form W-8 BEN AND/OR Non-US passport OR government ID evidencing
citizenship in another country
U.S. Resident Address / U.S. Mailing Address (including a U.S. post office box) (2) (3) Certification, Consent, and Waiver AND Form W-9 OR Form W-8,
U.S. Telephone Number (2) Form W-8 BEN AND/OR Non-US passport OR government ID evidencing
citizenship in another country OR Certificate of Loss of Nationality of the
Standing instruction/s to transfer funds to an account maintained in the U.S (2) US or Form I-407, OR a reasonable explanation of account holder's
renunciation of US citizenship OR the reason the account holder did not
Power of Attorney or signatory authority granted to a person with a U.S. Address (2) obtain US citizenship at birth
“In-care-of” address or “hold mail” address that is the sole address the Foreign Financial Institution has identified for the account holder (2)

CARDHOLDER SPECIMEN SIGNATURE (INSERT IMAGE OF SIGNATURE)

Please provide three specimen signatures.
1) 2) 3)

CARDHOLDER ATTESTATION (INSERT IMAGE OF SIGNATURE)

By my signature herein, I acknowledge that my company’s authorized HR representative has discussed and I have read the UnionBank ePaycard Terms and Conditions found in bit.ly/UBPePaycardTCs
and the Bank's Privacy Policy found in bit.ly/UBPDataPrivacy and I confirm that I fully understand and agree to abide by the terms stipulated and any future amendments thereto. For Checking
Account/s, I agree and undertake not to use cheques, printed or secured from printers, not accredited by your Bank and that I shall be held responsible and liable for any and all losses, damages arising
from the violation of this undertaking.
I confirm that all information I provided are true and correct. I agree to inform Union Bank of the Philippines should there be any changes to my personal data stated above. I consent to the disclosure of
my personal data to UnionBank and other authorized third parties, including subsidiaries and affiliates, of UnionBank to be used for the purpose of processing my application and for the assessment of
my compliance with the necessary requirements needed for this application. I understand that my personal information may also be used for review, audit, and reporting to Bangko Sentral ng Pilipinas
and other regulators.
Ultimately, I hold the Bank free from any liabilities that may arise regarding my account, including those that may arise from the Bank’s imposition of restrictions to or closure of my account that may be
due to incomplete, inaccurate, and/or outdated information provided by me or my company’s HR.

Esparas, Joanne Trinidad 7/9/2021

CARDHOLDER DATE
Signature Over Printed Name

7/9/2021
AUTHENTICATED BY AUTHORIZED HR REPRESENTATIVE
DATE
Signature Over Printed Name
FOR BANK'S USE ONLY (To be filled-out by the Sales Representative)
TYPE OF DEPOSIT CUSTOMER TYPE

EMPLOYER ID RM/ BM/ AO CODE

REMARKS

IDENTIFIED AND SIGNATURE VERIFIED BY DATE

PROCESSED BY DATE

APPROVED BY DATE

APPROVED BY (FOR EDD) DATE