Sunteți pe pagina 1din 2

REPUBLIC OF THE PHILIPPINES)

CITY OF NAGA)S.S.

AUTHORIZATION

I, KIRSTEEN A. BERTULFO, after being sworn in accordance with law, do hereby


authorize the following, pursuant to the provisions of Subsection X143.5 (c ) of the Manual of
Regulations for Banks, as amended by Circular No. 758 dated 11 May 2012:

a.Wealth Development Bank Corporation to conduct a background investigation on myself


relative to my application for appointment to the position of BRANCH SERVICE
OFFICER-TRAINEE in Wealth Development Bank Corporation which include, among
others, inquiring from Watchlist Files of the Bangko Sentralng Pilipinas; and

a.The Bangko Sentral ng Pilipinas to disclose its findings pertinent to the aforementioned
inquiry on the said watchlist files to Wealth Development Bank Corporation.

With the above authorization, I hereby waive my right to the confidentiality of the
information that will be obtained as a result of the said inquiry, provided that disclosure of said
information will be limited for the purpose of ascertaining my qualification or non-qualification
for the said position.

In Witness Whereof, I have hereunto set my hand this _______________________.

KIRSTEEN A. BERTULFO
(Signature Over Printed Name)

SIGNED IN THE PRESENCE OF:

_____________________________ ________________________________
(Witness) (Witness)
REPUBLIC OF THE PHILIPPINES)
CITY OF NAGA ) S.S.

ACKNOWLEDGMENT

BEFORE ME, this ____________________________ in the City of Naga personally


appeared the following person:

Name UMID CRN No. Place/Date Issued______


Kirsteen A. Bertulfo 0111-0839871-0 SSS NAGA CITY/May 24, 2018

known to me to be the same person who executed the foregoing instrument and he/she
acknowledged to me to be the same person who executed the foregoing instrument and he/she
acknowledged to me that the same is his/her free act and deed.

This instrument, consisting of two (2) pages, including the page on which this
acknowledgment is written; has been signed on the left margin of each and every page thereof by
KIRSTEEN A. BERTULFO and his / her witnesses, and sealed with my notarial seal.

In Witness Whereof, I have hereunto set my hand, the day, year and place above written.

Doc. No.______;
Page No.______;
Book No.______;
Series of 2018.

KIRSTEEN A. BERTULFO
(Signature Over Printed Name)

SIGNED IN THE PRESENCE OF:

___________________________ ____________________________

(Witness) (Witness)

S-ar putea să vă placă și