LANDBANK OF THE PHILIPPINES

Exhibit 2
Branch Santiago Branch

LANDBANK CASH CARD/PREPAID CARD ENROLLMENT FORM

Date: Feb 23, 2021
Please check the type of card being enrolled:

Purchaser's Information
Purchaser's Name: With existing account with LBP
karl redjie de veyra agpaoa if yes, pls specify Acct. No/s:
Cash Card Number/s:
ADDITIONAL INFORMATION FOR WALK-IN INDIVIDUAL PURCHASER, AND CARDHOLDER OF INSTITUTIONAL PURCHASER:
Cardholder's Name: Gender:
karl redjie de veyra agpaoa MALE
Marital Status:
Single
Permanent Address: Zip Code:
sapphire st, plaridel, 3311
SANTIAGO CITY, ISABELA
Present Address: Zip Code:
sapphire st, plaridel, 3311
SANTIAGO CITY, ISABELA
Place of Birth: Date of Birth: Nationality: Mother's Maiden Name:
santiago city Jul 29, 2000 PH djhoanna biltz de veyra

Type of ID Presented: ID Number Presented: Profession: TIN: Source of Fund:

Student ID 18-10079 Student 386-751-209-000 Other - Stipend

Name of Employer/Company/Business/School: Contact Number/s: Email Address: Gross Salary:

University of La Salette 9478537031 [email protected] P30,000 and below

Cardholder's Information
Cardholder's Name: Contact Number/s: Date of Birth:
karl redjie de veyra agpaoa 9478537031 Jul 29, 2000

Permanent Address: Zip Code: Relationship with:

sapphire st, plaridel 3311 the Purchaser
SANTIAGO CITY, ISABELA
Present Address: Zip Code: N/A
sapphire st, plaridel 3311
SANTIAGO CITY, ISABELA
Name to Appear on the Card (maximum of 22 characters):

Initial Load Amount of Fee/Charges to be paid:

(for Prepaid Travel Card) (for Cash Card/Regular Prepaid) (Initial Cost of the Card)

I/We hereby certify that the above information is true and correct:

Signature Over Printed Name Signature Over Printed Name

of Purchaser/Applicant/Authorized Signatory of Purchaser/Applicant/Authorized Signatory
FOR BANK'S USE ONLY
Processed by: Checked by: Approved by:

Customer Associate/NAC BOO/BSO Branch Head

Date/Time: ___________________ Date: ___________________ Date: ___________________
for Branches without BOO
Validation Print (if paid through cash):

CASH CARD/PREPAID CARD/PIN MAILER CLAIM STUB

Card Number: Card Holder's Name: Purchaser's Name: Date:

Prepaid Card Released by: PIN Haller Released by: Approved for Release: Card/PIN Mailer Recieved by:

Card Custodian PIN Mailer Custodian Branch Head/BOO/BSO Signature Over Printed Name
of Purchaser/Cardholder
Date/Time: ___________________ Date/Time: ___________________
Reminder/s:
- You may claim your Prepaid Card after 7 banking days for Metro Manila Branches, and 15 banking days for Provincial Branches, and a replacement fee shall be collected
- Unclaimed Prepaid Card/PIN Mailer shall be perforated after 120 calendar days (for CCT)/30 calendar days (regular) from issuance/re-issuance
- Please sign your Prepaid Card immediately
Validation Print (if debted from deposit account):
TES-01-02-02026-2019-08317-karl redjie de veyra agpaoa