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General Authorization Form Scribd

This document authorizes a representative to handle transactions for bank accounts. It lists the name and email of the authorized representative and the types of transactions they can perform like receiving statements, checking balances, and receiving returned checks. It also releases the bank from liability and waives privacy laws related to sharing account information with the representative.

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jenlimppiado.jtcenica
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1K views1 page

General Authorization Form Scribd

This document authorizes a representative to handle transactions for bank accounts. It lists the name and email of the authorized representative and the types of transactions they can perform like receiving statements, checking balances, and receiving returned checks. It also releases the bank from liability and waives privacy laws related to sharing account information with the representative.

Uploaded by

jenlimppiado.jtcenica
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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TO: BDO Shaw Blvd – Wack Wack Branch

GENERAL AUTHORIZATION

In connection with the following account/s maintained with Shaw Blvd – Wack Wack Branch, please be informed
that the person/s named hereunder is/are authorized to act as my/our representative/s for the transactions indicated herein.

ACCOUNT NUMBER/S :
ACCOUNT NAME/S :
Date : SEPTEMBER 15, 2023

Transactions to be handled:
1. Receipt of bank statements
2. Receipt of Checkbook Requisitions
3. Receipt of MC/DD/CC/GC
4. Receipt of Returned Checks, Replacement Passbook & Loan Documents
5. Updating of Passbook/ Receipt
6. Account Balance Inquiry
7. Receipt of Certificate on Confirmation of Participation / TD / IMA Disclosure Statement
8. Others (please specify)________________________________________________________

Name of Representative/s * Signature Email Address

DERALJEN LIMPIADO [email protected]

*To be submitted together with the photocopy of the representative's valid ID with picture and signature.

It is understood that this authorization shall remain valid and binding until cancelled in writing by the undersigned.
Likewise, for the transactions proposed by persons not listed above, a separate written authorization (with the transaction
indicated) shall be presented by such person.
Under this authorization I/we are permitting to disclose bank deposit and related information and hereby waive
my/our rights under Republic Act 1405 (Bank Secrecy Law, as amended), Data Privacy Act and other related secrecy laws
relative to confidentiality of my subject account and data.

I/we unconditionally and irrevocably render BDO Unibank, Inc., its officers, representatives, assigns and
successors (Collectively, the “Bank”) free and harmless from and shall indemnify it for and against any claim, liability,
cause of action, damages and demands whatsoever in law or in equity, the intention being to completely and finally release
BDO from any and all liabilities arising from or incidental to its acceptance and implementation the above authorization.
I/we also waive

Authorized Signatory / Depositor Authorized Signatory / Depositor


Signature Over Printed Name Signature Over Printed Name

____________________________ _____________________________

SIGNED IN THE PRESENCE OF:

_____________________________ _____________________________
Signature over printed name Signature over printed name

SUBSCRIBED AND SWORN to before me this _____ day of __________ 2022, the above individuals exhibiting to me
their Competent Evidence of Identity, as follows:
Name Competent Evidence of Identity Issued at Issued on

Notary Public
Doc. No. ____;
Page No._____;
Book No.____;
Series of 2022.

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