Deposit Account Application

Fill out the form below to open a deposit account with Lipa Bank Inc.

Account Type *

Initial Deposit Amount (₱) *

Preferred Branch *

Last Name *

First Name *

Middle Name

Date of Birth *

Gender *

Civil Status *

Present Address *

Permanent Address (if different)

Mobile Number *

Email Address *

Employment Type *

Employer / Business Name

Position / Nature of Business

Source of Funds *

TIN Number

Valid ID Type *

Valid ID Number *

Beneficiary Name

Relationship to Applicant

I certify that the information provided above is true and correct, and I agree to Lipa Bank Inc.'s terms and conditions for deposit account opening.