Security DigiBankerTM Activation

Activation
Request
Request
Form
Form
(To be properly/completely accomplished by SBC Referring Officer.) Date: (Pls print in legal size paper.)

CLIENT INFORMATION
Client Name : PCINERGY CONSULTING AND DEVELOPMENT CORPORATION
Nature of Business/Industry : CONSTRUCTION / CONSULTING
Tax Indentification No. : 009-412-191-000 EQCustomer No.
MAIN CONTACT PERSON: Upon processing of request, please indicate main contact person to be advised once request is processed.
Contact Person : ROBERTO R. INFANTE Contact Number/s 9065560298
Position/Department : TREASURER E-mail Address robertinfante888@gmail.com
CLIENT TYPE
New Account - Opening Date Existing Acct: Date Opened:
- Opening Balance -Php - YTD ADB as of _________ 200__:

New DigiBanker Client Existing DigiBanker Client (additional enrollment only)

New DigiBanker Lite Client - (APPLICABLE FOR NEW DIGIBANKER CONNECTIONS ONLY.)
For DigiBanker Lite Client, please specify availed DB Lite package and the committed ADB of Client:

DB Lite - Basic Package DB Lite - Plus Package DB Lite - Payroll /AutoCredit Package
Committed ADB in CASA: P Effectivity Month of ADB:
Card Pricing, please specify:
--> Please attach the DigiBanker Lite - Business Requirement Letter Page.
DIGIBANKER ACCESS AND PASSWORD ADMINISTRATOR
Creation of New Administrators in DigiBanker Change the existing administrator/s define in system to:
DigiBanker Adminstrators System Administrator Maker System Administrator Checker
Name LEODEGARIO H. PORRAL JR. ROBERTO R. INFANTE
Position/Department: VICE PRESIDENT TREASURER
Email Address leodegarioporral@gmail.com robertinfante888@gmail,com
Mobile Number 9053420344 9065560298

DIGIBANKER MODULES FOR ACTIVATION

DigiBanker Modules Business Requirement Agreed Upon with Client
1. Liquidity Management Account No/s. ADB Requirement Effectivity Mo.of ADB Fee (if any)
CASA Manager
Inquiry
Fund Transfer
iPASS Facility
IR2

2. Collection Facilities Account No/s. ADB Requirement Effectivity Mo.of ADB Fee (if any)
REPS (MERCHANT)
BIPPS (MERCHANT)
AutoDebit Collections Manager
UEP (MERCHANT)
PDC Manager

3. Disbursement Facilities Account No/s. ADB Requirement Effectivity Mo.of ADB Fee (if any)
AutoCredit Payments Manager
Payroll Manager
Check Payments Manager
-Check Issuance
-Releasing via SBC Branch/es:
-Releasing via LBC Branch/es:
Account No/s. ADB Requirement Effectivity Mo.of ADB
BIR eFPS RealTime
SSS RealTime
PhilHealth RealTime
PAS5 ePayment
Pag-IBIG RealTime
REPS(PAYOR)
Merhant Name:
BIPPS(PAYOR)
Merhant Name:
UEP(PAYOR)
OTHER CASH MANAGEMENT SERVICES OUTSIDE DIGIBANKER MODULES
ADB Requirement Effectivity Mo.of ADB Fee (if any)
CheckRight
Bills Payment (Proprietary Channels)
Bancnet Bills Payment
BancNet eMerchant
Bancnet POS
SUBMITTED DOCUMENTS
Board Resolution -Account Opening (AUTHENTICATED COPY) Board Resolution -DigiBanker (AUTHENTICATED COPY)
Copy of Signature Card/s (AUTHENTICATED COPY) Enrollment Forms:
Important Note: The MOA should be signed on ALL PAGES by Client's authorized representative/s. Signature of client should be signature
verified by the Branch Service Manager.
Digibanker Main Agreement (CASA Manager) PAS5 ePayment Pag-IBIG RealTime
I-Pass Auto-Debit Approval on WAIVER on fees/charges:
IR2 Check Cutting Disbursing Guidelines (in case SBC or LBC will release MCs)
REPS-Merchant REPS -Payor Payroll Manager
BIPPS-Merchant BIPPS -Payor Payroll Service Agreement : ____________________________
PDC Manager Auto-Credit Payments Manager UEP Merchant Agreement
BIR-eFPS SSS RealTime and R7 UEP Payor A
PhilHealth RealTime , Certificate of Registration and Philhealth Official Receipt Others :
OTHER REQUEST/S: (Please specify.)

REFERRING OFFICER / UNIT/ BRANCH INFORMATION (Cash Management Tagging)

Please complete the necessary information below.
Referring Officer Name:
Position: (Please check.) Corbank Relationship Manager Banking Center : *** Center
S&D Branch Manager S&D Sales Officer
S&D Relationship Officer For S&D: Branch/Area Assignment:
*** For Banking Center referred deal, the cash management tagging will be booking to Main Depository Branch.
Email Address : Contact Number/s
REFERRING OFFICER TRANSACTION BANKING DIIVISION EBANKING
(TO BE SIGNED BY REFERRING OFFICER Approved by (ABM/RM): REVIEWED BY: APPROVED BY: Enrolled by:
SOLUTIONS DELIVERY HEAD CASH MANAGEMENT DIVISION HEAD
INDICATED ABOVE) (In case of pricing deviation only)

Name: Name:
Date: Date: Date: Date: Date: