AUTHORIZATION FORM FOR QUERYING THE BANGKO SENTRAL WATCHLIST FILES FOR SCREENING APPLICANTS AND CONFIRMING APPOINTMENTS OF DIRECTORS AND OFFICIALS
(Appendix to Section 138 on Watchlisting)
A U T H O R I Z A T I O N
a) (Name of Bank), to conduct a background investigation on myself relative to my application for or appointment to the position of (position) in (Name of Bank) which include, among others, inquiring from the Watchlist Files of the Bangko Sentral; and
b) The Bangko Sentral to disclose its findings pertinent to the aforementioned inquiry on the said watchlist files to (Name of Bank).
____________________________
(Signature Over Printed Name)
SIGNED IN THE PRESENCE OF:
Witness | Witness |
____________________________________________________________________________
ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES )
PROVINCE/CITY OF ) S.S
Name | Comm. Tax Cert. No. |
Date of Issue | Place of Issue |
known to me to be the same person who executed the foregoing instrument and he acknowledged to me to be the same person who executed the foregoing instrument and he acknowledged to me that the same is his free act and deed.
IN WITNESS WHEREOF, I have hereunto set my hand, the day, year and place above written.
Notary Public
Doc. No. : ______________
Page No.: ______________
Book No.: ______________
Series of __________.
(Circular No. 969 dated 22 August 2017)