Auto Debit Arrangement Enrollment Form

ADA Request Form
Payor Details
Last Name, First Name Middle Name Suffix
Agent/Dealer/Distributor/ Policy No., etc
Agent/Dealer/Distributor/ Policy No., etc
Bank Account Details
Account No. must be 13 digit number
Account No. must be 13 digit number
Account No. must be 13 digit number
For single account, select "1". For joint accounts, select the number of joint accountholders.
Account's Signatory
Mobile No. must be registered with the Security Bank Account 
Mobile No. must be registered with the Security Bank Account 
Email Address must be registered with the Security Bank Account
Account's First Signatory
Mobile No. must be registered with the Security Bank Account 
Mobile No. must be registered with the Security Bank Account 
Email Address must be registered with the Security Bank Account
Account's Second Signatory
Mobile No. must be registered with the Security Bank Account
Mobile No. must be registered with the Security Bank Account
Email Address must be registered with the Security Bank Account
Account's Third Signatory
Mobile No. must be registered with the Security Bank Account
Mobile No. must be registered with the Security Bank Account
Email Address must be registered with the Security Bank Account
Account's Fourth Signatory
Mobile No. must be registered with the Security Bank Account
Mobile No. must be registered with the Security Bank Account
Email Address must be registered with the Security Bank Account
Account's Fifth Signatory
Mobile No. must be registered with the Security Bank Account
Mobile No. must be registered with the Security Bank Account
Email Address must be registered with the Security Bank Account
Grant of Authority and Waiver of Confidentiality

I hereby certify that all information herein are true and correct based on my own knowledge and further authorize the Bank to obtain information as it may require concerning my loan application and agree that it shall remain the Bank's property whether my loan is approved or not. Any information given by me or other persons I authorized which is not true or accurate, will automatically cause the Bank to reject my loan or cancel its approval.

I hereby willingly, voluntarily, and with full knowledge of my right under the law, waive the right to confidentiality of information and authorize the Bank to disclose, divulge and reveal any such information relating to the account of the Borrower/Mortgagor, including events of default, for the purpose of, among others, client evaluation, credit reporting or verification and recovery of the obligation due and payable to the Bank under the terms and conditions of this agreement.

In view of the foregoing, the Bank may disclose, divulge and reveal the aforementioned information to third parties, including but not limited to my employer, the Bank's affiliates, subsidiaries, agents or services providers, the Bankers' Association of the Philippines - Credit Bureau (BSP - CB) or to any similar central monitoringentity or recipients as provided for by law and required by competent authority.

I further authorize the Bank, as my Attorney-in-Fact, to conduct random verification with the Bureau of Internal Revenue (the "BIR") in order to establish the authenticity of my Tax Statements (the "ITR") and the accompanying financial statements/documents submitted to the BANK in accordance with banking regulatory requirements.

I hold the Bank free and harmless from any and all liabilities, claims and demands of whatever kind or nature in connection with or arising from the aforementioned disclosure or reporting.

I hereby acknowledge that the Loan or any part(s) thereof shall be deemed to have been availed on the date on which funds are transferred to my bank account maintained with the Bank, or receipt of the Manager's Check reflecting the amount of the loan less applicable fees, charges and taxes.

I further authorize the Bank to deduct from my Loan proceeds all fees including, but not limited to, processing fees, documentary stamp tax, notarial fees and interest accruals should the first due date be over 30 days from the release of my loan and other related charges.

I/We also agree that the appraisal report will be forwarded directly to the Bank for its sole use only.

I likewise authorize the Bank to provide me with a consumer loan or additional bank product/s (such as but not limited to auto, personal loan, credit card and other products suited to my situation) at the Bank's sole discretion. My acceptance of the credit card or the proceeds of any loan released pursuant thereto shall be conclusive proof of my acknowledgement of my additional obligations and/or indebtedness to the Bank under the Terms and Conditions set forth by the Bank and prevailing at the time the credit card is issued or the additional loan is approved.

I hereby agree that should my application be denied, the Bank has no obligation to furnish the reason for such rejection or to return my application and other submitted documents.

I/We further certify that the proceeds of the loan, if this application is approved, will be used solely for the purpose stated in this application.

The foregoing shall continue to be in full force and effect until my/our loan obligation with the Bank has been fully extinguished.  This authority shall also cover subsequent renewals, extensions, increase and availments and/or re-availments of my/our loan accommodation with the Bank.

I also legally bind myself to the Terms and Conditions of the Promissory Note, Disclosure Statement and other relevant documents that I shall execute in favor of the Bank.

Terms and Condition
  1. The Bank shall be notified immediately of any and all changes in my/our reference/policy number(s);
  2. I/We agree to waive the application of R.A. 1405 (Secrecy of Bank Deposits Law) and hereby authorize the bank to disclose to the mentioned Company/Institution/Beneficiary on this form any matter pertaining to my/our linked or depository accounts (listed on this form) as may be necessary for the operation of this AutoDebit Arrangement;
  3. Only the cleared and withdrawable balance of the account shall be debited; in the event that there is no withdrawable balance on debit date, my account/s can be redebited as necessary. If no payment was debited from my account by the Bank for whatever reason, I understand that the mentioned Company/Institution/Beneficiary will not consider that amount to have been paid. This is without prejudice to my making a separate arrangement with the Company/Institution/Beneficiary for the settlement of my amount due; 
  4. Any discrepancy between the billing amount and the debited amount shall be resolved with the mentioned Company/Institution/Beneficiary;
  5. Payments made shall be for amounts due; 
  6. The AutoDebit Collection Arrangement between the Bank and the mentioned Company/Institution/Beneficiary may be cancelled at anytime by either party with notice of termination to me/us; 
  7. This agreement shall be governed by all applicable rules and regulations of the Bangko Sentral ng Pilipinas;
  8. The Bank may in the future impose charges on this arrangement within legal and regulatory limits.
  9. All terms and conditions of my/our existing savings/current/CashLink Plus account agreement(s) with the Bank insofar as not inconsistent herewith shall remain in full force and effect;
  10. The Bank shall not be held liable for any adverse actions/consequences instituted by the mentioned Company/Institution/Beneficiary for payment made on overdue or past due accounts, policy revision, and/or the like;
  11. I/We hold the Bank and other members of the Bank as well as any of their officers and representatives free and harmless from any and all liabilities, claims, demands, suits of whatever nature, arising out of or in connection with the implementation of this arrangement, including any and all errors and/or omissions inadvertently committed resulting to the Bank’s failure to effect any payment transaction that I/We may undertake via the AutoDebit Collection Arrangement, unless the Bank is guilty of gross negligence or willful misconduct and there is no contributory negligence on my/our part ; I/we understand and accept that if I/we submit a new enrollment form with new instructions or details, I am authorizing the Bank to effect the concomitant change of in my existing enrollment, if any, and I accept that the transition or change could result in a possible failure to effect a pending payment transaction via the ADC.
  12. The depositor may terminate this authority upon thirty (30) days written notice to the mentioned Company/Institution/Beneficiary;
  13. I/We hereby agree to waive separate notice of debit other than that reflected in the Bank’s statement.
  14. For inquiries and comments, the Depositor may contact the BANK’s Customer Service hotline at +632 8887-9188, 1-800-1-888-1250 (Toll- free for PLDT landlines) or email the BANK at [email protected]. Security Bank Corporation is regulated by Bangko Sentral ng Pilipinas. (https://www.bsp.gov.ph).

  1. I/We shall be responsible for all the acts and shall bear all the security risks which are not directly attributable to the willful misconduct and gross negligence of SBC;
  2. I/We undertake to indemnify and hold SBC free and harmless against any and all claims, damages or liabilities which have arisen or may arise resulting from or in any manner be connected with the instructions under this letter, provided that the same are not directly attributable to the to the willful misconduct and gross negligence acts of SBC.
  3. This serves as a standing instruction to SBC and shall be valid unless amended or revoked in writing by me/us.
ADA Request
Payor Details
Bank Account Details
Account's Signatory
Account's First Signatory
Account's Second Signatory
Account's Third Signatory
Account's Fourth Signatory
Account's Fifth Signatory


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Underlying documents required 

  • Download the files and save them on your device [insert links to MTAF, TTAF, etc…] 
  • Open the files using your device’s PDF reader. 
  • Fill in all the fields.  
  • Print a copy of the file. 
  • Sign the document using a wet signature. 
  • Submit the MTAF or TTAF to your desired branch (Please
    coordinate with your corporation’s RM for pick up/drop off instructions) 

Download the Money Transfer Application Form 

Download the Telegraphic Transfer Application Form

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