CORPORATE ENROLLMENT

eFPS eGOV
Branch:

This document, once signed, shall be deemed valid and enforceable upon submission to China Banking Corporation for activation.

GOVERNMENT AGENCY NUMBER

SSS No. Tax Identification No.
Philhealth No. HDMF Pag-ibig No.
COMPANY / BUSINESS INFORMATION
Registered Corporate Name / Business Name CIF No.

Company Address (Unit No./Floor, Building Name, Building No., Street, Subdivision/Village, Barangay, City/Municipality, Province, ZIP Code) Date of Incorporation
(mm/dd/yyyy)

Contact Number(s) E-Mail Address

Contact Person (Last Name, First Name, Middle Name) Designation

Account Number(s) to be Linked CIF No(s).

Savings Account No. Current Account No.
Account Name Account Name
Relationship of the Company / Business and the Account Number(s) to be linked to it

USER SECURITY DESIGNATION / ACCESS PARAMETERS / CORPORATE ADMINISTRATION INFORMATION

Corporate User 1 (Last Name, First Name, Middle Name) Role 2 E-Mail Address
M A FA
User Name 3 CAN 4

Corporate User (Last Name, First Name, Middle Name) Role E-Mail Address
M A FA
User Name CAN

Corporate User (Last Name, First Name, Middle Name) Role E-Mail Address
M A FA
User Name CAN

Challenge Question (maximum length of 50 characters) Challenge Answer (minimum length of 5 characters, maximum length of 20 characters)

A single Challenge Question and Challenge Answer shall be set for each company and shall be entered by all users during the initial log on. It is the responsibility of each u ser to enter a new Challenge Question and
Challenge Answer, which will serve as his own for the succeeding log ons, and maintain confidentiality of the same.

Authorization Requirement:

Corporate Administration User (Last Name, First Name, Middle Name) Designation

Corporate Administration User is the designated personnel to enroll the Maker, Checker and Authorized Approver.
Contact Number(s) E-Mail Address

Corporate User / Final Authorizer Government

Role CAN 4
(Last Name, First Name, Middle Name) Agency
M C AA

M C AA

M C AA

1 Corporate Users

2 Role M Maker M Maker designated personnel to initiate or encode the payment transaction
A Authorizer C Checker designated personnel to verify and approve the payment transaction initiated by the Maker
FA Final Authorizer AA Authorized Approver designated personnel authorized to execute final approval and completion of the payment transaction
3 User Names
4 Corporate Access Number (CAN) Card

Note ach government agency.

Received By / Date Reviewed By / Date Approved By / Date Received By / Date Issued By / Date
BRANCH
CAN CARD
Received By / Date Processed By / Date Checked By / Date
ACD

Received By / Date Processed By / Date Checked By / Date Received By / Date Issued By / Date
CMSD
PIN
Remarks ENVELOPE

Distribution:
 CHINA BANK e-GOV AND/OR BIR eFPS CORPORATE ENROLLMENT FORM

1. APPLICABLE RULES AND REGULATIONS

6. RESPONSIBILITY FOR TRANSACTIONS

(i.e.,username,
password, security question and answer)

For BIR eFPS:

2. USERNAME / PASSWORD / CAN / PIN / ANSWER TO SECURITY QUESTION 7. DISCLOSURE OF INFORMATION

(for e-Gov only)

3. CARD OWNERSHIP

8. SERVICE CHARGES

4. ONLINE ACCESS

9. HOURS OF AVAILABILITY

10. SERVICE CANCELLATION

For e-Gov:

5. ONLINE PAYMENT

11. COST AND VENUE OF SUIT

12. SEVERABILITY PROVISION

13. AMENDMENT TO TERMS AND CONDITIONS