MORNBFI Vol. 1 - Planters Development Bank

APP. Q-4508.12.31AUTHORIZATION FORM FOR QUERYING THE BANGKO SENTRALWATCHLIST FILES FOR SCREENING APPLICANTS AND CONFIRMINGAPPOINTMENTS OF DIRECTORS AND OFFICIALS(Appendix to Subsecs. 4143Q.5, 4143S.6, 4143P.6 and 4143N.6)A U T H O R I Z A T I O NI, , after being sworn in accordance with law, dohereby authorize the following, pursuant to the provisions of Subsecs. 4143Q.5(c), 4143S.6(c),4143P.6(c) and 4143N.6(c) of the MORNBFI:a) (Name of NBFI) to conduct a background investigation on myselfrelative to my application for or appointment to the position of (position)in (Name of NBFI) which include, among others, inquiring from the Watchlist Filesof the BSP; andb) The BSP to disclose its findings pertinent to the aforementioned inquiry on the saidwatchlist files to (Name of NBFI) .With the above authorization, I hereby waive my right to the confidentiality of theinformation that will be obtained as a result of the said inquiry, provided that disclosure ofsaid information will be limited for the purpose of ascertaining my qualification or nonqualificationfor the said position.IN WITNESS WHEREOF, I have hereunto set my hand this ________________.______________________________(Signature Over Printed Name)SIGNED IN THE PRESENCE OF:(Witness) (Witness)Manual of Regulations for Non-Bank Financial Institutions Q RegulationsAppendix Q-45 - Page 1