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SUPPLEMENTANY CAND NEQUEST FONM

KINDLY CHECK AS APPLICABLE
I NEw f] EXISTING and for updaring of infornstion

1. Must be at leasi thitreen (13) years ojd upon srbmission of the lorm and requirements.
2. Must proyide a copy of a valid and unexpi.ed photo-bBaring lD.
3. P.opedy {i'led oui request {arm with signature of both principal cardhold€r and nomi.aied supplementary eardholder.

Name

Name Membersh'p tee rorthe fr61 supplemenbry cardholder is FREE FOR UFE.

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Nalure of Businessllndusly Source of Fuods

(Salary. Busif,ess. Romitance. Peniion, €t..)

O* ldenttulion NlmhJ

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By signing below. I (We) confirm that

1 . All the statements, information and supporting documents provided by me (us) are true, correct. and accurate.
2. Any material misrepresentations or falsity or omission herein which is misleading shall be construed as an act to defraud Bank of the
Philippine lslands (''BPl") and may be a ground {or the denial of my (our) application or, if already granted, the cancellation or termination
thereof, including rendering any loans granted to me (us) immediately due and payable, without prejudice to such civil and/or criminal liabitity
action that BPI may pursue against me (us).
3. ltisthesoleprerogativeofBPltograntordenymy(our)applicationandshouidmy{our)applicatronbedenied,BPlrnayprovidethereason
for such decision in accordance with the requirements of applicable law.
4. All information and documenls obtained, collected and processed by BPI in connection with my (our) application shall remain the property
of BPI.
5. BPl, its subsidiaries and affiliates (collectively, the "BPl Group of Companies") may impose such specific terms, conditions and requirements
as tl-tey may deem necessary or appropriate in connection wilh my (our) availment of any of their products, services, facililies and channels.
ItilylOur application, enrollment, availment, access, maintenance and continued use of any of the products, services, facilities and channels
of any member of BPI Group of Companies shali constitute my/our acceptance and agreement to the applicable terms and conditions.
6. I (We) shall notify BPI of any material changes affecting the information supplied by me/us and documents submitted rn connection with this
application.
7. I (We) agree to receive updates, notices and announcements on my (our) application andior any of BPI's products, services, facilities and
channels via Sl\tlS/text, email or fax transmission or such other means of communication deemed appropriate by BPl"
8. Where applicable, Bpl may enroll my (our) approved application with any credit protection provider, or guarantee program o{ any institution,
whether public or private, at BPI'S sole option.
9. Prior to submitting to BPI information about individuals (including their personal data), I (we) have obtained all necessary authorizations and
consents as may be required by applicable confidentiality and data privacy laws to enable BPI to use and process such inforrtation. I (we)
further agree that all my (our) personal information (including those of individuals related to me(us), my (our) transactrons, business and
credit relatlonships, accounts or account information or records which are with you. made available to you or which are tn your possession
or updated from time to time, may be collected, obtained, used, stored, consolidated, processed, profiled, benchmarked, shared to and
disclosed, by and between BPI and any member of the BPI Group of Companres, their successors and assiqns. and their respective
auihorized representatives. agents and service providers, for any or all the purposes described in the Data Privacy Statement published at
https:/ionline.bpi.com.ph and deemed incorporated by reference in this form.
10. l (we) have read, understood and agree to be bound by BPI's "Terms and Conditions of the Deposits. Products, Services, Facilities and
Channels", as well as BPI's "Terms and Conditions Governing the lssuance and Use of BPI Credil Cards", as these terms and conditions
may be amended or supplemented lrom time to lime, copies of which were either provided to me (us) or made available laccessible to me
(us) via www.bpi.com.ph or such other channels or electronic applications seiected by BPI.
11. The foregoing shall apply to all products, services, facilities and channels of BPI thal I (we) may now or hereafter apply for or avail of.

Foi inquiries asd comments, please send !s a message ihrough M-bpi.com.ph/contactus or call
00 c 0J, our 24-hour BPI Contact Center at (*632) 889-10000

lx tz Bank ofthe Phiiipptne ,slands is reguleted lry Bangko Sentml ng Pi{ipinas. htlpsr/ww-bsp.gov.ph.
The info.@ation cootained in this form is accurato as ol printing dale (0812021) and is subject to
change afier such date.