Company Name Company Code

User Enrollment Form

Last Name, First Name, Middle Initial Mobile Number Email TIN Last Name, First Name, Middle Initial Mobile Number Email TIN
Service Account Number(s) Role Class Action Service Account Number(s) Role Class Action
☐ Account Portfolio ☐ Account Portfolio
☐ Statement of Account ☐ Statement of Account
☐ Checkbook Re-order ☐ Checkbook Re-order
☐ Stop Payment Order ☐ Stop Payment Order
☐ Transfer to Own ☐ Transfer to Own
☐ Account Sweeping ☐ Account Sweeping
☐ Reverse Sweeping ☐ Reverse Sweeping
☐ PESONet ☐ PESONet
☐ InstaPay ☐ InstaPay
☐ ADA ☐ ADA
☐ Paywise ☐ Paywise
☐ Bills Payments ☐ Bills Payments
☐ ePay ☐ ePay
☐ EC Writer ☐ EC Writer
☐ EC Online ☐ EC Online
☐ eTax ☐ eTax
Other Services Other Services
☐ ☐
☐ ☐
☐ ☐

AUTHORIZATION RULES
Amount With Chkbk Transfer Acct Reverse Bills EC EC
Currency Verifier Auth Rules SPO PESONet InstaPay ADA Paywise ePay eTax
From To Order to Own Sweep Sweep Pay Writer Online

CONFORMITY TO THE TERMS AND CONDITIONS

By signing this document, I/we confirm the validity and accuracy of all the information stated herein this form and that I/we have enforced all necessary measures to eliminate the possibility of any unauthorized person gaining
access to or making use of our company’s enrolled solutions in PNB C@shNet Plus system. I/We also acknowledge that I/we have read, understood and accepted the Terms and Conditions governing the use of the same.

DATA PRIVACY CONSENT STATEMENT

By signing this document, I/we hereby consent to the collection and processing of my/our information, including personal data, that will be used solely for facilitating enrollments of Customer and Customer User information and
transmission of advisories related to the use of the PNB C@shNet Plus system including any related usage/transactions to the foregoing as stated in the Terms and Conditions. All personal data will be processed in accordance
with the Bank's Data Privacy Policy provided in the Bank's website (www.pnb.com.ph) and applicable data privacy laws, rules and regulations as maybe amended from time to time.

Signature over Printed Name Signature over Printed Name Signature over Printed Name Signature over Printed Name
FOR BANK USE ONLY Please use additional sheets as necessary.
NOMINATING BRANCH ENDORSED FOR ENROLLMENT TO THE For ACTION, please indicate
FOLLOWING FACILITIES: A – add U – update D - delete
Signature Verified By Approved By
For ROLE, please indicate
M – maker V – verifier A – authorizer
I – inquiry only R* – releaser
*(applicable to Checkwriting services only)
(Printed Name & Signature / Date) (Printed Name & Signature / Date)

Form No. CMS001.1 Rev. Dec. '21

Jan '22