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BIR Koronadal EMDS Access Form

This document is a user request and certification of access rights form for the Electronic Money Disbursement System submitted by the Bureau of Internal Revenue to the Land Bank of the Philippines branch in Koronadal City. It adds two new users, Rosanie N. Binsuan and Heidi-Louise Quieta Tabule, and specifies their roles, account access rights, and authorizers for transactions. It is signed by the new users and authorizing officials to certify the new user access rights.

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Revelyn Aragon
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255 views3 pages

BIR Koronadal EMDS Access Form

This document is a user request and certification of access rights form for the Electronic Money Disbursement System submitted by the Bureau of Internal Revenue to the Land Bank of the Philippines branch in Koronadal City. It adds two new users, Rosanie N. Binsuan and Heidi-Louise Quieta Tabule, and specifies their roles, account access rights, and authorizers for transactions. It is signed by the new users and authorizing officials to certify the new user access rights.

Uploaded by

Revelyn Aragon
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
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CLASS D

Land Bank of the Philippines BRANCH KORONADAL Date September 1, 2022


USER REQUEST/CERTIFICATION OF ACCESS RIGHTS FORM FOR EMDS (FOR AGENCY)

AGENCY NAME : BUREAU OF INTERNAL REVENUE RR 18, KORONADAL CITY LANDLINE FAX
CONTACT NOS.
(083) 228-1009
DATE OF
AGENCY ADDRESS: BRGY. CONCEPCION, KORONADAL CITY, SOUTH COTABATO AGENCY CODE _________________ Organization Code 110031100018
NAME OF USERS BIRTH
(MMDDYYY FUNCTION/
FIRST NAME MIDDLE NAME LAST NA ACTION USER ID Y) TIN ROLE EMAIL MOBILE NO. MOTHERS MAIDEN NAME USER SIGNATURE
1 REVELYN T. ARAGON A RTA12 12201991 426-483-885-000 MAKER [email protected] 09177063797 FE GANTALAO TUMALA
2

AUTHORIZATION RULE INFORMATION


APPROVE ADVICE OF ISSUED CHECKS PHILGEPS APPROVE NTA APPROVE LDDAP-IC
MDS Account Number/s MDS Account Number/s MDS Account Number/s MDS Account Number/s
1 2075-9012-45 3 0752-1142-00 1
2 2075-9012-45 1 2075-9012-45 3. 0752-1142-00 1 __2075-9012-45_______ 3
4 _0752-1142-00__________
2 2075-9015-96 4 ________________2 2075-9015-96 2 2075-9015-96 2 __2075-9015-96_______ 4 ____________________

AUTHORIZER/S AMOUNT RANGE AUTHORIZER/S AMOUNT RANGE AUTHORIZER/S AMOUNT RANGE AUTHORIZER/S AMOUNT RANGE
1 ALMA P. PALERO 1 ALMA R. PALERO 1 ALMA R. PALERO 1 ___ ALMA R. PALERO
2 EDITH C. YAP 2 EDITH C. YAP 2 EDITH C. YAP 2 ___ EDITH C. YAP
APPROVE ADVICE OF CANCELLED CHECKS APPROVE CHECKBOOK REQUEST (AGENCY)
MDS Account Number/s MDS Account Number/s
1 2075-9012-45 3 0752-1142-00 1 2075-9012-45 3 __ 0752-1142-00

2 2075-9015-96 4 _________________ 2 2075-9015-96 4 ____________________


AUTHORIZER/S AUTHORIZER/S ______________________
1 ALMA R. PALERO 1 ALMA R. APLERO AUTHORIZED SIGNATORY/DATE
2 EDITH C. YAP 2 EDITH C. YAP

REMINDERS
ACTION : A-Addition; C- Change in Unit/Position/User's Personal Information D-Deletion; L- Lifting R-Reset Password
User ID : ID defined by Agency(Employee ID of the user*Minimum of 4 Alphanumeric Characters, Maximum of 6
Function/Role : Role to be defined in the system "MAKER/AUTHORIZER"

FOR SERVICING BRANCH:

______________ ____________________ _______________________


PROCESSED BY/DATE VERIFIED/CHECKED BY/DA APPROVED BY/DATE

DISTRIBUTION : COPY 1- AGENCY COPY 2- BRANCH


CLASS D

Land Bank of the Philippines BRANCH _KORONADAL Date September 1, 2022


USER REQUEST/CERTIFICATION OF ACCESS RIGHTS FORM FOR EMDS (FOR AGENCY)

AGENCY NAME : BUREAU OF INTERNAL REVENUE RR 18, KORONADAL CITY LANDLINE FAX
CONTACT NOS.
(083) 228-1009
DATE OF
AGENCY ADDRESS: BRGY. CONCEPCION, KORONADAL CITY, SOUTH COTABATO AGENCY CODE _________________ Organization Code 110031100018
NAME OF USERS BIRTH
(MMDDYYY FUNCTION/
FIRST NAME MIDDLE NAME LAST NA ACTION USER ID Y) TIN ROLE EMAIL MOBILE NO. MOTHERS MAIDEN NAME USER SIGNATURE
1 ROSANIE N. BINSUAN A RNB2024 082165 134-694-171 [email protected] 9638114978 MANA-AY
AUTHORIZER
2 HEIDI-LOUISE QUIETA TABULE C HLQT2024 021371 194-560-260 [email protected] 9517259574 QUIETA
AUTHORIZER
3
AUTHORIZER
4

AUTHORIZATION RULE INFORMATION


APPROVE ADVICE OF ISSUED CHECKS PHILGEPS APPROVE NTA APPROVE LDDAP-IC
MDS Account Number/s MDS Account Number/s MDS Account Number/s MDS Account Number/s
1 2075-9012-45 3 0752-1142-00 1
2 2075-9012-45 1 2075-9012-45 3. 0752-1142-00 1 __2075-9012-45_______ 3
4 _0752-1142-00__________
2 2075-9015-96 4 ________________2 2075-9015-96 2 2075-9015-96 2 __2075-9015-96_______ 4 ____________________

AUTHORIZER/S AMOUNT RANGE AUTHORIZER/S AMOUNT RANGE AUTHORIZER/S AMOUNT RANGE AUTHORIZER/S AMOUNT RANGE
1 ROSANIE N. BINSUAN 1 ROSANIE N. BINSUAN 1 ROSANIE N. BINSUAN 1 ___ ROSANIE N. BINSUAN
2 EDITH C. YAP 2 EDITH C. YAP 2 EDITH C. YAP 2 ___ EDITH C. YAP
APPROVE ADVICE OF CANCELLED CHECKS APPROVE CHECKBOOK REQUEST (AGENCY)
MDS Account Number/s MDS Account Number/s
1 2075-9012-45 3 0752-1142-00 1 2075-9012-45 3 __ 0752-1142-00

2 2075-9015-96 4 _________________ 2 2075-9015-96 4 ____________________ ROSANIE N. BINSUAN/01/11/24 ATTY. EDITH C. YAP/ 01/11/24
AUTHORIZER/S AUTHORIZER/S OIC-Asst. Chief, AHRMD Asst. R
1 ROSANIE N. BINSUAN 1 ROSANIE N. BINSUAN AUTHORIZED SIGNATORY/DATE AUTHO
2 EDITH C. YAP 2 EDITH C. YAP

REMINDERS
ACTION : A-Addition; C- Change in Unit/Position/User's Personal Information D-Deletion; L- Lifting R-Reset Password
User ID : ID defined by Agency(Employee ID of the user) *Minimum of 4 Alphanumeric Characters, Maximum of 6
Function/Role : Role to be defined in the system "MAKER/AUTHORIZER"

FOR SERVICING BRANCH:

______________ ____________________ _______________________


PROCESSED BY/DATE VERIFIED/CHECKED BY/DA APPROVED BY/DATE

DISTRIBUTION : COPY 1- AGENCY COPY 2- BRANCH


9517259574
9638114978

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