SWORN DECLARATION AND UNDERTAKING RELATING TO APPLICATION AND ENROLLMENT IN THE PSSLAI VISA CARD, AND OTHER ELECTRONIC SERVICES

I, Filipino, of legal age, single/married, and a bonafide member of the Public Safety Savings and Loan Association, Inc. (PSSLAI), under oath, hereby declare that:

1. I possess the legal capacity to execute the instrument and I am not suffering from any incapacity under the law;

2. I have enrolled in the PSSLAI iTrack and other electronic services (eServices) facility through registration of my 10-digit SIM (Subscriber Identity Module) number, membership number, and/or email address which may serve as my user identification under the iTrack and other eServices such as but not limited to the PSSLAI Bilis Online, PSSLAI Bilis Mobile app, and Kiosk;

3. I understand and agree that I may avail of the PSSLAI VISA card, iTrack, and other eServices for as long as it is offered by the PSSLAI and provided that I continue to be qualified under its terms and conditions;

4. I understand and agree that any violation or breach of the terms and conditions as well as my undertakings herein set forth may result in the immediate temporary or permanent suspension, cancellation or revocation by the PSSLAI of my use, access and/or availment of the PSSLAI VISA card, iTrack and other eServices;

5. I confirm that I have been apprised of and have fully been informed of the terms, mechanics and workings of the PSSLAI VISA card, iTrack, and other eServices, as well as the benefits and risks of enrolling in, availing of and/or using the same, including the applicable charges corresponding to each service, prior to the application and enrollment in the PSSLAI VISA card, iTrack, and other eServices and executing this Sworn Undertaking in relation to the same;

6. I understand and agree that all transactions, data and information relating to my account, deposit and/or investments which are facilitated, transmitted, coursed through, conveyed and/or recorded through the PSSLAI VISA card, iTrack, and other eServices as well as the PSSLAI VISA card Personal Identification Number (ATM PIN), which I nominated through the PSSLAI Bilis Online or PSSLAI Bilis Mobile app, iTrack Mobile Personal Identification Number (MPIN) provided by me for accessing iTrack, and the Membership Card with Personal Identification Number (PIN) provided to me for accessing the Kiosk (hereafter collectively referred to as the “Information”), are highly confidential in nature and that it is my sole responsibility to ensure the confidentiality and security of the information. I, therefore, undertake to observe extraordinary diligence in protecting/securing the information from third parties, including the Government and its offices, agencies or instrumentalities as well as the courts of law and officials, employees and agents of the latter;

7. I understand that any information personal or sensitive as defined by R.A. No. 10173 shall be collected, used and processed by PSSLAI to pursue its legitimate interest as a savings and loan association. I also authorize the Association to disclose my information to accredited/affiliated third parties for purposes of enforcing and/or implementing the provisions of any agreement that I may have executed with it, including but not limited to Promissory Notes, Deeds of Undertaking and Special Power of Attorney (SPA). I hereby confirm that by providing personal data, I agree to be bound by the PSSLAI Privacy Notice found in www.psslai.com;

8. I likewise understand that the information is covered by the Bank Secrecy Laws of the Philippines, Section 6 of Republic At No. 8367 (The Revised Non-Stock Savings and Loan Associations Act of 1997) and Section 4652s (Confidential Information) of the Regulations Governing Non-Stock and Savings and Loan Associations under the Manual of Regulations For Non-Bank Financial Institutions (MORNBFI) issued by the Bangko Sentral ng Pilipinas (BSP). Therefore, I expressly undertake not to disclose or divulge the information or any portion thereof to third parties including the Government and its offices, agencies or instrumentalities, as well as any court of law and officials, employees and agents of the latter without coordinating with the PSSLAI and securing its written consent to such disclosure;

9. I hereby authorize PSSLAI to facilitate all transactional requests, inquiries and responses communicated using my enrolled/registered 10-digit SIM number and/or email address in all PSSLAI eServices such as but not limited to the PSSLAI Bilis Online, PSSLAI Bilis Mobile App, and Kiosk;
10. I authorize PSSLAI to recognize and honor my nominated usernames and passwords that may be required by all PSSLAI eServices and hereby accept full responsibility for all transactions executed using my nominated username and passwords;

11. I authorize PSSLAI to use my electronic/digital signature as communicated to and from my enrolled 10-digit SIM number and/or email address in the event that such is required by PSSLAI;

12. I hereby accept full responsibility and accountability for all instructions under the iTrack and eServices that come from and/or are executed via my 10-digit SIM number. I understand that the PSSLAI shall consider as lawful, valid and binding upon myself and the Association any instructions made and coming from my 10-digit number corresponding to the SIM card registered under my account in iTrack and eServices and that my liability shall not be affected, diminished, or obliterated by the fact that the account be accessed without my consent or knowledge. The PSSLAI shall not be obliged to investigate the authenticity of the instructions bearing my said 10-digit SIM number. I understand and agree, however, that the PSSLAI may, if it deems necessary, verify any such instructions with me via telephone or any other means of communication;

13. I have provided herein an email account that I maintain and use myself, and for which I am fully responsible and accountable. Thus, the Association shall honor any request communicated through the email account indicated in this enrollment form or in my membership profile;

14. I expressly undertake to hold the PSSLAI or any of its officers, employees, agents or assignees free and harmless from any liability, charges or obligation arising from my enrolment in availment of and use of the PSSLAI VISA card, iTrack, and eServices as well as from any unauthorized action or transaction coming from the 10-digit SIM number and email address registered under my account in the PSSLAI VISA card, iTrack, and eServices. I likewise expressly undertake to hold the PSSLAI or any of its officers, employees, agents or assignees free and harmless from any liability, charges or obligation arising from the use of information under the PSSLAI VISA card, iTrack, and eServices as well as the disclosure upon intentional or unintentional causes, of the information or any portion thereof to third parties;

15. In connection with my enrolment in and availment of the PSSLAI VISA card, iTrack, and eServices, I hereby authorize the PSSLAI or any of its officers, employees, agents, and/or assignees the right to inspect or audit the enrollee for the purpose of validating strict compliance with the obligations herein whenever such are relevant, for verification, records reconciliation and audit purposes or whenever such is necessary to improve the services under the PSSLAI VISA card, iTrack, and eServices or to troubleshoot and/or correct or attend to any error, malfunction or complaint by me relating to my availment and use of the PSSLAI VISA card, iTrack, and eServices (hereafter, the “Examination”). For the said purpose, I expressly undertake to hold the PSSLAI or any of its officers, employees, agents, and/or assignees free and harmless from any liability, charges or obligation for official actions in connection with the “Examination”;

16. I understand and agree that the PSSLAI may cancel and/or refuse to execute any of my instructions via the PSSLAI VISA card, iTrack, and eServices at any time, without prior notice, without the PSSLAI incurring any liability, if such instructions are, as evaluated by the PSSLAI, against the law or regulations, or detrimental to the Association;

17.I understand that PSSLAI may require the submission or update any document necessary as part of its documentation requirements in relation to this application;

18. In the event of change in enrolled iTrack number, email address or other secured identification numbers and processes to be implemented in the future, said request shall be supported by either of the following: - A written request from the member if change request shall be made over the counter; or - A request concurrence if change is made through the Kiosk using the membership ID and other secured applications using biometrics;

19. It is my responsibility to inform PSSLAI with regard to changes or updates in my personal information. I hereby hold PSSLAI free & harmless from any loss, pecuniary or otherwise, as a result of my failure to update or disclose any of my personal information;

20. In the event of a lost SIM, I agree and understand that I should notify PSSLAI through its Member Care Hotline at 0998-9622081, 0917-8567443, and 0925-5457493 or membercare@psslai.com and for lost PSSLAI VISA card email my concern to visamarketing@psslai.com. Upon PSSLAI’s receipt of report, I understand that I will be temporarily disconnected from the PSSLAI VISA card, iTrack, and eServices;

21. I expressly undertake to make use of the PSSLAI VISA card, iTrack, and eServices solely for lawful purposes and transactions;

22. I understand and agree that there will be charges per text/transaction to be debited from any of my PSSLAI Account pertaining to my application and any change that I may request;

23. I also understand that I will be charged the necessary fees for reactivation/change of iTrack Number, Email address, replacement of lost PSSLAI VISA card, and other details done via eServices, via personal request, or any other future processes to be implemented by the Association; and

24. I declare under the penalties of perjury that all information I made covering this application has been made in good faith and to the best of my knowledge and belief, is true and correct based on authentic records.