Account Information Enrollment Form

CUSTOMER NAME: JOCOMALEE CONSTRUCTION SUPPLY REQUEST DATE:

Company Address: ACASIA STREET FAIRVIEW SUBDIVISION BRGY. KASMBAGAN CEBU CITY
Contact Number: 09177288880
Nature of Business: CONSTRUCTION SERVICES
TIN: 407-869-913-001
GSIS/SSS: 8000965998
Business Type: ☒Sole Proprietor ☐Partnership ☐Corporation
If Corporation, Holding Company? ☐Yes ☒No

Account Tick additional service/s as applicable

Manager’s Check
Corporate Check

Present and Pay

Business Payment
Account Sweep
Number Services

Warehousing
(Select (Select One)

Direct Debit

Integrated
Payments

AR Recon
One)

PayCard
Gateway
Account Number Currency

Payroll
Check

Trade
DELETE

DELETE

CAR
ADD

ADD

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Enroll Accounts from Other Banks for Account Viewing

Account Number
Account Number Name of Third Party Bank Currency
ADD DELETE
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Once these account numbers are enrolled to the Customer’s Electronic Banking (EB) access, the bank’s Standard
Offerings shall automatically be available to these accounts.

Customer acknowledges and agrees that its use of EB Services is subject to and conditioned upon full compliance with
the EB Terms and Conditions, including any amendments, supplements and additions thereto made at any time and
from time to time by METROBANK.

By: ___________________________________ By: ___________________________________

(Authorized Signatory’s Signature over Printed Name) (Authorized Signatory’s Signature over Printed Name)
NAME: BENIGNO JOSE C. LEONCIO NAME: MARIA JOSIELENA A. INDOYON
POSITION: PROPRIETOR POSITION: LIAISON OFFICER
DATE: DATE:

FOR BANK USE ONLY

Endorsed by: Date: RM Number:

Processed by: Checked by:

Electronic Banking Account Information Enrollment Form (2019)

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MB-I-M-254-t/Feb.’19
Account Information Enrollment Form Guide

Field Description Example

COMPANY INFORMATION
Customer Name Complete registered company name ABC Incorporated
Request Date Date when the form was filled out January 1, 2018
Company Address Complete registered company address 1/F ABC Building, DEF
Street, GHI City
Contact Number Official company telephone/cellphone number 999-9999 or
(at least 7 digits) 999-999-9999
Nature of Business Industrial Classification according to the Philippine Standard Wholesale of industrial
Industrial Classification (PSIC) chemical products
TIN BIR-registered Tax Identification Number 123456789 or
(9, 12 or 13 digits only) 123456789012 or
1234567890123
GSIS/SSS Company’s GSIS or SSS-issued number (10 digits) 1234567890
Business Type Select from the choices indicated by ticking () either Sole -
Proprietor, Partnership or Corporation.
If Corporation, Tick () Yes if the Corporation is a Holding Company -
Holding Company? Tick () No if the Corporation is not a Holding Company

ACCOUNT INFORMATION
Account Number Tick () Add to Add an Account Number -
(Select One) Tick () Delete to Delete an Account Number
Account Number Enter account number to be added or deleted. 999-9-999-999999
Metrobank account numbers consist of 13 digits.
Currency Currency denomination of the account PHP/USD/GBP/JPY/AUD
Services (Select Tick () Add to Add a Service
One) Tick () Delete to Delete a Service
Additional service/s Tick () additional services as applicable. Standard Offerings -
are automatically linked to all accounts.

OTHER BANKS ACCOUNT INFORMATION

Account Number Tick () Add to Add an Account Number -
(Select One) Tick () Delete to Delete an Account Number
Account Number Enter account number to be added or deleted. 1234-5678-90
Name of Third Party Name of Bank of Third Party account to be enrolled ABC Bank
Bank
Currency Currency denomination of the account PHP/USD/GBP/JPY/AUD

Account Information Enrollment Form: Fill-Out Guide (2019)

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MB-I-M-254-t/Feb.’19