FORMAT OF AFFIDAVIT ON TRANSACTIONS INVOLVING VOTING SHARES OF STOCKS
[Appendix to Sec. 122]
REPUBLIC OF THE PHILIPPINES)
_____________________ ) S.S.
1. I am the subscriber, purchaser, transferee, or recipent of (state quantity) shares representing___________________percent of voting stocks of (state name of bank), hereinafter to be referred to as “Bank”, by virtue of (state instrument of subscription, purchase/sale, transfer, acquisition, etc.) dated____________.
2. In acquiring equity in the Bank, I acted with full awareness and understanding that the Bank is a duly organized domestic banking corporation, exercising and enjoying a right, franchise and privilege to engage in banking business, decreed by law to be a nationalized industry, wherein at least____________percent of the voting stock should be owned by citizens of the Philippines and that there exist prohibitions under the law against the holding by any person, of voting shares of stock in excess of____________of the voting shares of stock of the Bank.
I am also aware of the requirement for prior Monetary Board approval of significant ownership of voting shares of stock by any person, natural or juridical, or by one (1) group of persons as provided in Sec. 122 of the Manual of Regulations for Banks (MORB).
3. Consonant with the policy of the Government as provided for in Commonwealth Act No. 108, as amended (The Anti-Dummy Law) and R. A. No. 8791 (The General Banking Law of 2000), I hereby declare as follows:
a. The (state instrument of transfer) was not simulated to evade the provisions of the Constitution and Commonwealth Act No. 108, as amended, or the provisions of R. A. No. 8791, particularly Sections 11, 12 and 13 imposing maximum equity holdings by any person, whether natural or juridical, in banks;
b. That I acquired said voting shares of stocks for valuable consideration from my own funds;
c. As such subscriber, purchaser, transferee, or recipient, I have title over said voting shares of stock; and That I am the bona fide owner of voting shares of stock of the bank in my own right, and not as an agent, assignee, proxy, nominee or dummy of any person, whether natural or juridical.
d. That I am the bona fide owner of voting shares of stock of the bank in my own right, and not as an agent, assignee, proxy, nominee or dummy of any person, whether natural or juridical.
4. This Affidavit is executed for the purpose of stating under oath my bona fide title over the voting shares of stocks of the Bank; that in acquiring title over said voting shares I gave valuable consideration; and that I shall comply with the requirements of all laws, rules and regulations with respect to my conduct as stockholder of the Bank.
Doc. No. _____________
Page No. _____________
Book No. _____________
Series of _____________