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RWALLET CASH CARD APPLICATION FORM  New Card  Replacement Card

CARDHOLDER INFORMATION
Complete Name (Last Name, First Name, Middle Name) Sex: Male  Female 

Name on Card (maximum of 25 characters)

Present Address:

Permanent Address:

Date of Birth:
Nationality:  Filipino  Others:______________
Place of Birth:
Civil Status:  Single  Married  Others: ______________
Contact Number: SSS / GSIS / TIN : _______________
Company ID number : ____________________
Email Address: Occupation:

Beneficiary
Name Present Address Birthdate Birthplace Nature of Work Source of Fund

I hereby certify that all the information set forth herein are true and correct.

_________________________
Signature of Cardholder

Robinsons Bank Cash Card and the value stored therein are not deposit accounts and are not insured by
Philippine Deposit Insurance Corporation (PDIC).
*** Please see and sign the terms and conditions at the back of this page ***

SOURCE OF FUND INFORMATION

Source of Fund: Purpose of Purchase:
Allowance or benefit from employer
Name of Employer: Relationship to the Source:
 Employer  Others:________________
Present Address: Contact Number:

Nature of Business/Occupation: Date of Incorporation: (mm-dd-yyyy)

ACKNOWLEDGEMENT RECEIPT (for bank use only)

Cash Card Number: 5 0 5 7 9 0 - - - -
Type:  New Released by: Received by:
 Replacement
Date: Date:
Signature Verified by: Checked by: Approved by:

Robinsons Bank Corp. Robinsons Bank Corp.

 TERMS AND CONDITIONS OF THE ROBINSONSBANK CASH CARD

ROBINSONS BANK CASH CARD – a pin-based prepaid multi-purpose beyond the control of Robinsons Bank, fortuitous events such as, but not limited
electronic value card that can be used as a debit card for banking and other to prolonged power outages, breakdown in computers and communication
lawful transactions locally. Robinsons Bank Cash Card shall not earn any facilities, typhoons, floods, public disturbances and calamities, and other similar
deposit interest, can only be redeem at face value and is not considered as a related cases; (ii) loss or damage which the Cardholder may suffer arising out of
deposit account. Robinsons Cash Card is not insured with Philippine Deposit any fraudulent or unauthorized utilization of Cash Card due to theft or
Insurance Corporation (PDIC). The Cash Card may be issued to Corporate and unauthorized disclosure of PIN or violation of other security measures with or
Retail clients. As used hereunder, “Cardholder” shall refer to the named or without the Cardholder’s participation and/or arising out of authorized use of the
designated Cardholder of the Cash Card or its/his authorized holder of the Cash Card; (iii) inaccurate, incomplete or delayed information received due to
Cash Card when applicable. disruption or failure of any communication facilities used for the Cash Card; (iv)
mechanical defect in or malfunction of the electronic device on which the Cash
CASH CARD OWNERSHIP – The Cardholder acknowledges that the Card is, Card is used (i.e. ATM, POS etc.); the Cash Card not being honored or being
and shall remain to be the property of Robinsons Bank and may be revoked and declined; any delay in the crediting of funds or debiting of payment from the Cash
withdrawn by Robinsons Bank at anytime for violation of any of the terms and Card due to or by reason of failure and/or malfunction of any mechanical,
conditions stated herein and for any other reason(s), which in the opinion of electronic or other part, component system or network upon which the
Robinsons Bank, would prejudice the interest of either Robinsons Bank or the ATM/branch computer is critically dependent for normal and efficient operations;
Cardholder arising from the continued use of the Cash Card. The Cardholder and/or (v) improper, unauthorized use of the Cash Card’s facilities and electronic
agrees to return the Cash Card to Robinsons Bank upon demand. devices (i.e. ATM, POS etc.); or recklessness or accident in connection with the
use thereof. Further, Robinsons Bank shall not be liable for any indirect,
CASH CARD ACTIVATION – Robinsons Bank Cash Card is activated on the first incidental, or consequential loss, loss of profit or damage that the Cardholder
ATM transaction. may suffer or has suffered by reason of the use or failure or accident in
connection with the use thereof, or inability to use the Cash Card under the terms
CASH CARD RELOAD – Robinsons Bank Cash Card can be reloaded with of this Agreement. This provision shall survive the termination or suspension of
additional value by the authorized Corporate Fund Source, provided that the the right to use the Cash Card.
Cardholder does not exceed the maximum allowable load limit of the Cash Card.
LIMITATION OF LIABILITY – Subject to the above “non-liability” provision,
CASH CARD USAGE/FEES – Robinsons Bank Cash Card can be used to do Robinsons Bank’s liability for any loss or damage that the Cardholder may incur
any of the following transactions: (i) balance inquiry; (ii) purchase items/goods at arising from the use of the Card shall not exceed P100,000.00 or the actual
accredited merchants; (iii) change Cash Card pin and; Cardholder recognizes proven amount lost, whichever is lower.
Robinsons Bank’s right to impose charges and other fees, on any or all of its
products, services and facilities. i.e. P 100.00 per month for inactivity, P 100.00 COMPLIANCE WITH EXISTING LAWS – The Cardholder hereby warrants that
for card replacement. Cardholder agrees to apply such fees presently imposed, his/her use of the Cash Card, specifically, the transfer and/or receipt of funds thru
or may in the future be imposed by the sole option of Robinsons Bank. As the use of the Cash Card, does not and will not violate the applicable provisions
necessary, the amount may be revised from time to time. Robinsons Bank also of the Anti-Money Laundering Act, including any and all amendments, other
reserves the right to terminate, suspend, or penalize the Cardholder once the pertinent laws, government rules or regulations. The Cardholder hereby renders
Cash Card is rendered inactive, mishandled, used for any illegal acts, or its Robinsons Bank free and harmless from any liability whatsoever which may arise
retention is not in the best interest of Robinsons Bank. Termination may be done from the Cardholder’s violation of any of those mentioned.
without prior notice to Cardholder.
CASH CARD SERVICE – If the Cardholder is enrolled under a particular
RESPONSIBILITY OF THE CASH CARDHOLDER – Cardholder shall be Robinsons Bank Cash Card Service (i.e. payroll, remittance etc.), and for as long
responsible for the use and safety of the Cash Card. Cardholder shall in all as he/she is enrolled as such, the Cardholder agrees to be bound by the terms
circumstances assume full responsibility on all transactions processed using the and conditions of the existing Cash Card Service Agreement, in so far as may be
Cash Card, whether or not processed with Cardholder’s knowledge or authority. applicable. In case of conflict between the provisions of this Terms and
Conditions and the Cash Card Service Agreement, the latter shall prevail.
LOST/STOLEN/DAMAGED CASH CARD- Cardholder shall immediately notify
Robinsons Bank Customer Care Center 637-2273 (CARE) in case of loss, and AGREEMENT TO THE TERMS AND CONDITIONS – Cardholder hereby agrees
shall be liable for any damages caused by such loss. Upon compliance with the that his/her signature on this Application Form constitutes the Cardholder’s
requirements set by Robinsons Bank and the payment of corresponding fee/s as Agreement to these Terms and Conditions.
solely determined by Robinsons Bank, a new Cash Card will be issued to the
Cardholder. Any outstanding balance of the Cash Card may be transferred to COMPLAINT LODGING – Cardholder can lodge a complaint through Robinsons
the new Cash Card number after the settlement/deduction of the fee/s which may Bank Customer Care Center number +63 2 6372273 or email
be due Robinsons Bank. [email protected], or in writing addressed to Robinsons Bank
Customer Care Center 17th Floor Galleria Corporate Center, EDSA corner
REPLACEMENT OF LOST/STOLEN/DAMAGED CASH CARD- Cardholder must Ortigas Avenue, Quezon City; or through any Robinsons Bank Business Center.
submit to Robinsons Bank an affidavit of loss, presentation of valid IDS, and
other requirements as may be prescribed by Robinsons Bank pertaining to the Cardholder needs to provide sufficient information and the nature of concern or
lost/stolen/damaged Cash Card. Damaged Cash Card shall be replaced upon complaint. Robinsons Bank shall process at the earliest upon receipt of the
surrender of said Cash Card. complaint and within reasonable timeframe. Robinsons Bank shall notify the
Cardholder on the resolution of my/our complaint within seven (7) banking days
INACTIVE CASH CARD – Cash Card shall be considered inactive if there are no from receipt of my/our complaint by the bank. Except for unreasonable delay in
client-initiated financial activity after two successive years. The corresponding fee rendering resolution or gross negligence or serious misconduct, Robinsons Bank
per month shall be imposed from the start of the inactivity. When Cash Card shall not be liable for any and all costs, expenses or damages arising from the
balance reaches P0.00, it will automatically be cancelled. incident complained of.

A client-initiated financial activity is defined as a credit to the Cash Card account I/We hereby acknowledge to have read, fully understood and agree be governed
by the Corporate Fund Source or a purchase of items/goods from accredited by the said terms and conditions.
merchants through the POS machine by the Cardholder.

AMENDMENT – Robinsons Bank reserves the right to amend or supplement this

agreement without any prior notice. Cardholder hereby agrees to be bound by ________________________________
such changes and shall not cause for the termination on the use of the Cash Signature of Account Holder
Card after the effective date of change.

NON-LIABILITY – Robinsons Bank shall not be liable for any loss/damage of

whatever nature in connection with transactions involving the Cardholder’s use of
the Cash Card, in any of the following instances: (i) disruption, failure or delay
relating to or in connection with Cash Card transactions due to circumstances