eGOV APPLICATION FORM
Branch:
EMPLOYER DETAILS
Account Name:
Account No.
146-01-000179-4
CHESVET STEEL CORPORATION
Registered Employer Name:
CHESVET STEEL CORPORATION
Employer Address:
BYPASS ROAD BRGY. ANAO MEXICO PAMPANGA
Number of Employee/s:
Email Address: CHESVETSTEEL@GMAIL.COM
70
Daily Transaction Limit (in PESOS)
Tel. No./Mobile No. 09199999966
eGOV AUTHORIZED ADMIN USER DETAILS
Name of Authorized User:
Email Address:
LEIDEL CAGUIOA
LEIDELCAGUIOA.CHESVET@GMAIL.COM
Department: ADMIN DEPARTMENT
Designation:
Employer ID No.
SSS
80-0201758-5-000
Philhealth
007000020924
HDMF
209529610001
TIN
778-656-340-0000
CONFORME
This is to confirm the participation of our Company in the AUB's eGov Payment System using the BancNet web portal.
I/We hereby certify that I/We have read and understood the terms and conditions governing the product and service of this application that is found in
https://www.aub.com.ph/bizkit/tc?bizkitProd=egov. I/We hereby confirm that upon approval of this application, and for as long as the product and service is installed
in our device/s, I/We shall be bound by such terms and conditions, as the same may be amended from time to time, given that I/we have full authority to sign, execute
and deliver this application for and on behalf of the company.
I/We hereby authorize the ADMIN User as indicated in this application who has the authority to apply/enroll via online in the eGov System. As ADMIN User, he/she is
hereby authorized and instructed to conform to all the terms and conditions of eGov Payment System including subsequent modifications and amendments thereto as
well as to assign, replace, or change Users or act as User/s who may access eGov Payment System and their corresponding access levels, it being understood that
any an all transactions entered into by the ADMIN User or the Users assigned shall be considered fully authorized and valid by the Company without the need for the
Bank to inquire as to whether the same be entered into for this Company's business or benefit or in accordance with the conferred authority.
I/We hereby undertake to abide to the required average deposit balance (ADB) of Pesos: ___________________________ (Php) ________________ to be
maintained with in my/our deposit account no. _____________________________and to pay the corresponding fees of Pesos: ______________________ which
shall be automatically debited from my/our account should the deposit balance fall below the required ADB. To the minimum extent required and necessary to
implement the automatic debit arrangement and determination of ADB contemplated hereunder, I/We hereby waive my/our rights under bank secrecy laws, rules and
regulations.
Furthermore, I/We including our Authorized User(s) (i.e. Approvers and Makers) hereby authorize and consent to the collection, transfer, processing, storage,
disclosure and handling of my/our personal information in accordance with the data privacy policy of AUB found in https://www.aub.com.ph/privacyPolicy.
Finally, it is understood that the information contained herein is correct and true as of date of enrollment, and shall remain in effect until correctors or changes are
transmitted in writing to all affected parties.
By Authorized Corporate Signatories:
Signature over printed Name / Date
Signature over printed Name / Date
By Authorized ADMIN User(s):
LEIDEL CAGUIOA 09-19-2023
Signature over printed Name / Date
Signature over printed Name / Date
FOR BANK USE ONLY
Solicitor Name
Employee No.
BizKit Product Sub-Type
Select from drop down list
Received by:
Signature Verified By:
Signature over Printed Name / Date
Approved By:
Signature over Printed Name / Date
Signature over Printed Name/Date
CORPORATE'S ACKNOWLEDGEMENT (VIRTUAL ATM)
Virtual Card No:
PIN and Card Received By
(Authorized Admin User):
Signature over Printed Name / Date
CMU/eGov V. 08.08.2023
Released By:
Signature over Printed Name / Date