CUSTOMER ACCOUNT

INFORMATION FORM
Member: Philippine Stock Exchange, Inc. and SIPF
17/F Tower One & Exchange Plaza Ayala Triangle,
Ayala Avenue, Makati City, Philippines 1226

Customer ☐ Individual Account ☐ Cash ☐ Discretionary For Online Account

Type: ☐ Joint Type: ☐ Margin ☐ Directional User ID: Platform:
1st Choice _______________________ (tick one)
☐ “or” 2nd Choice _______________________
☐ Web
☐Mobile App
☐ “and” 3rd Choice _______________________

PERSONAL INFORMATION PRIMARY ACCOUNTHOLDER SECONDARY ACCOUNTHOLDER

Last Name
First Name
Middle Name
Date of Birth
Place/Country of Birth
Citizenship/Nationality
SSS/GSIS/Passport/PhilSys No
TIN
Contact Number
Email Address
(All notices including trade confirmation orders shall be
sent to this email address of the primary account holder)
Room No./Office Name, Bldg./House No., Street, Subd./ Brgy. Room No./Office Name, Bldg./House No., Street, Subd./ Brgy.
Permanent/ Address Line 1
Residential
Address Address Line 2 District, Town, City District, Town, City
(All official
communication
letters Residential
Province Country Zip Code Province Country Zip Code
Address of the Address Line 3
primary account
holder)

BUSINESS INFORMATION
Occupation
Employment Status
Name of Employer/Business
Nature of Business
Office/Business Contact No.
Room No./Office Name, Bldg./House No., Street, Subd./ Brgy. Room No./Office Name, Bldg./House No., Street, Subd./ Brgy.
Office/Business Address Line 1
Address District, Town, City District, Town, City
Address Line 2
Province Country Zip Code Province Country Zip Code
Address Line 3

INVESTOR PROFILE
Financial Gross Annual ☐ Less than P500K ☐ P10M to P25M ☐ Less than P500K ☐ P10M to P25M
Information Income ☐ P500K to P1M ☐ P25M to P40M ☐ P500K to P1M ☐ P25M to P40M
☐ P1M to P5M ☐ Over P40M ☐ P1M to P5M ☐ Over P40M
☐ P5M to P10M ☐ P5M to P10M
Net Asset ☐ Less than P500K ☐ P10M to P25M ☐ Less than P500K ☐ P10M to P25M
☐ P500K to P1M ☐ P25M to P40M ☐ P500K to P1M ☐ P25M to P40M
☐ P1M to P5M ☐ Over P40M ☐ P1M to P5M ☐ Over P40M
☐ P5M to P10M ☐ P5M to P10M
Net ☐ Less than P500K ☐ P10M to P25M ☐ Less than P500K ☐ P10M to P25M
Worth/Capital ☐ P500K to P1M ☐ P25M to P40M ☐ P500K to P1M ☐ P25M to P40M
☐ P1M to P5M ☐ Over P40M ☐ P1M to P5M ☐ Over P40M
☐ P5M to P10M ☐ P5M to P10M

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Investment ☐ Speculation ☐ Preservation of Capital ☐ Speculation ☐ Preservation of Capital
Objective/Trading ☐ Growth ☐ Others (Pls. specify) ☐ Growth ☐ Others (Pls. specify)
Strategy _______________ _______________
No. of Years of ☐ Less than 1 ☐ 5 to 10 ☐ Less than 1 ☐ 5 to 10
Investment Experience ☐ 1 to 5 ☐ Over 10 ☐ 1 to 5 ☐ Over 10

Preferred Mode of sending Client Communications (i.e. Confirmation Receipt, Statement of Accounts, Receipts, etc.)
☐ via Email to the primary accountholder ☐ via regular mail to the Client address indicated above
Name: Relationship:
Do you want to duplicate ☐ Yes
the confirmation letter? Email Address:
☐ No

Shares Standard Settlement Instruction

☐ MSPH to safe keep ☐ Deliver to Custodian
Investment Purchased in
Custodian Name Custodian Address
Client’s behalf

Cash Standard Settlement Instruction

This serves as my/our standard settlement instruction and grants authority for Maybank Securities, Inc. to transfer, remit, pay, and turnover all proceeds, including
but not limited to cash from my/our cash equity trading account’s selling transactions and cash dividends received by Maybank Securities, Inc. on my/our behalf, to
the bank account specified below. These instructions will remain in effect until revoked by me/us in writing.
Bank Account Name Bank Name Bank Account Number Bank Swift Code Bank Address

Schedule of Fees and Other Charges

Commission Rate: I affix my signature herein to indicate my acceptance of the stipulated Rates and Charges.
________ Client Signature/ Initials:___________________________
Transaction Fees Transfer Related Fees Other Fees
Stock Transaction Tax: 6/10 of 1% of Transaction Value PDTC EQ IN Trade Fee: PHP 75 per issue Handling Fee for cross border conversion: PHP 2,200
PSE Transaction Fee: 0.00005 of Transaction Value PDTC EQ OUT Trade Fee: PHP 200 per issue BSRD Fee: PHP 1,000 per request
SCCP Fee: 0.0001 of Transaction Value Lodgement Fee: Php 330 + 50 for the succeeding certificates Request for Certification of Portfolio: PHP 200
Upliftment Fee: Php 370 Financial Confirmation of Portfolio: PHP 200

DISCLOSURES
If yes, provide Company Name If yes, provide Company Name
Are you an officer or director of a ☐ Yes ☐ Yes
PSE listed company? ☐ No If yes, provide Position
☐ No If yes, provide Position

If yes, provide Company Name If yes, provide Company Name

Are you a shareholder, director, ☐ Yes ☐ Yes
officer, or employee of another ☐ No If yes, provide Position
☐ No If yes, provide Position
broker/dealer?
Pls. list down the name of brokers Pls. list down the name of brokers
Do you have account with ☐ Yes ☐ Yes
another broker? ☐ No ☐ No
Pls. list down the names including Pls. list down the names including
Are you aware of any relative/s ☐ Yes relationship
☐ Yes relationship
maintaining account with us? ☐ No ☐ No
If yes, please provide US TIN If yes, please provide US TIN
Are you a US Citizen/US ☐ Yes ☐ Yes
Person/US Permanent Resident ☐ No ☐ No
(Green Card)?

CLIENT UNDERTAKING, DECLARATION AND AUTHORIZATION

I/We acknowledge having read and understood the terms and conditions (hereinafter referred to as "Agreement")
available on the Maybank Securities, Inc. ("MSPH") website at https://maybank-atrke.com/terms_conditions.asp and a
copy of which has been sent to my/our email address indicated above. I/We confirm that the Agreement accurately
reflects our understanding and intent. Consequently, I/we hereby release MSPH from any liabilities, obligations, losses,
damages, penalties, actions, judgments, costs, suits, expenses, or disbursements of any kind whatsoever that may arise
in relation to this Agreement or the transactions it contemplates, or from enforcing its terms.

I/We hereby represent and warrant on a continuing basis that:

1. I/We have thoroughly reviewed and comprehended the Terms and Conditions governing the MSPH Products,
Services, Facilities & Channels, including the Terms and Conditions of the Maybank Securities Online Equity Trading
Facility (hereafter referred to as “Online Trade Facility”). I/We agree to be bound by these terms, acknowledging that

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Please sign here: _________________________ ____________________________

they may be amended or supplemented over time.

2. I/We authorize MSPH to debit and/or credit, or cause to be debited and/or credited, the necessary amounts to
my/our Settlement Account to facilitate transactions related to the Online Trade Facility.

3. I/We will promptly notify MSPH in writing of any changes to the data, information, and documents that I/we have
provided or submitted in connection with the Online Trade Facility.

4. I/We authorize MSPH, or any member of the Maybank Investment Banking Group or Maybank affiliates, to obtain,
disclose, share, update, furnish, and/or process any personal or privileged information that may be required for
managing and implementing transactions, for further verification, and updating of my/our account information. I/We
expressly waive any rights under confidentiality laws applicable in the Philippines or other jurisdictions, including but
not limited to RA 1405 (Law of Secrecy of Bank Deposits), RA 6426 (Foreign Currency Deposit Act), and RA 8791 (The
General Banking Law) that may impede such actions.

5. By enrolling, registering, or availing of any services provided under the Online Trade Facility, I/We agree to comply
with and be bound by the Terms and Conditions governing the MSPH Products, Services, Facilities & Channels, as well
as those of the Online Trade Facility, as they may be amended, revised, updated, modified, or supplemented from time
to time.

FATCA Declaration:

I/We hereby consent for Maybank Securities, Inc. (“MSPH”) to report my information to regulatory authorities in
accordance with the requirements of Foreign Account Tax Compliance Act as may be stipulated by applicable laws,
regulations, agreement or regulatory guidelines or directives.

I/We hereby consent that the MSPH may withhold from my account(s) such amount in accordance with the
requirements of Foreign Account Tax Compliance Act as may be stipulated by applicable laws, regulations, agreement,
or regulatory guidelines or directives.

I/We hereby consent that the MSPH may classify me as a recalcitrant account holder and/or suspend recall or terminate
my account (s) and/or facilities granted to me, in the event I fail to provide accurate and complete information and/or
documentation as MSPH may require.

I undertake to notify MSPH in writing within 30 calendar days if there is a change in any information which I have
provided to the MSPH.

Data Privacy Consent

I/We read, understood and hereby agree and consent to the Data Privacy Consent and Privacy Notice published in
Maybank Securities Website at https://www.maybank-atrke.com/privacy_security.asp.

In addition to the above and with regards to promotional and marketing materials: (place a check mark on your choice;
if no mark is indicated, it will be considered as “No”)
 Yes, I/we expressly agree to allow the Maybank Group and/or other entities to process my/our personal data
to receive promotions, advertisements about Maybank products, and/or to use my/our personal data for
promotional and marketing purposes.
 No, I/we do not consent to the processing of my/our personal data by the Maybank Group and/or other entities
for the purpose of receiving promotional and marketing materials..

Authorization and Consent

I/We, the undersigned ("CLIENT" and/or "CO-CLIENT"), hereby authorize and empower Maybank Securities, Inc. and its
representatives to establish and manage a Name-on Central Depository (NoCD) account on our behalf, which will be
lodged with the Philippine Depository and Trust Corporation.

By signing this document, I/We each expressly consent to and authorize Maybank Securities, Inc. to:
 Collect, process, and utilize our Personal/Corporate Information as necessary for the creation and maintenance
of the NoCD account.;
 Disclose our Personal/Corporate Information as required to process transactions and to facilitate the delivery
of other services or products provided by the Corporation that we have availed ourselves of, as well as for other
stated purposes; and
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Please sign here: __________________________ __________________________

  Retain and utilize our Personal/Corporate Information for the duration necessary to achieve the purposes for
which it was collected, in order to comply with legal, regulatory, and internal requirements.

I/We hereby declare under penalty of perjury that all information provided herein is accurate and correct, based on
my/our personal knowledge. We further authorize MSPH to verify this information through any sources it deems
appropriate.

Applicable for Online Joint Account Only

Maybank Securities, Inc. has fully informed, and we, the undersigned Retail Joint Account Clients, understand and agree
that:
a. The Online Trading Facility allows for only one (1) set of log-on credentials, consisting of a username and password,
for each Online Account/Joint Account.
b. The Online Trading Facility is not equipped to support multiple log-on credentials for each Online Account/Joint
Account.
c. The log-on credentials provided will be designated for use by a single authorized Retail Joint Account Client (the
“Designee”).
In view of the foregoing:

1. We, each of the Retail Joint Account Clients for the Online Account/Joint Account specified below, hereby designate
and authorize one among us as the Designee:
Joint Account Name: ____________________________________________
Designee: _____________________________________________________.

2. The Designee stated above has the full authority to create and assign a username and password (collectively as “log-
on credentials”) which shall be used by said Designee to gain access to the Online Trading Facility and place Instructions
for the Online Account/Joint Account.

We, the Retail Joint Account Clients, hereby affirm and agree that any instructions, orders, or transactions executed
using these log-on credentials are ratified and fully authorized by all of us, collectively confirming our responsibility and
consent to any and all actions taken by the Designee.

CLIENT Conforme and Specimen Signature

PRIMARY ACCOUNTHOLDER SECONDARY ACCOUNTHOLDER
Signature 1

______________________________ __________________________
Signature over Printed Name Signature over Printed Name
Signature 2
_______________________________ __________________________
Date Signed

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