ANNEX A
(As amended by Circular Nos. 698 dated 5 Nov 2010, 794 dated 18 Apr 2013, 925 dated 13 Sep 2016,
984 dated 22 Dec 2017, 1030 dated 5 Feb 2019 and 1124 dated 10 Aug 2021)
APPLICATION TO PURCHASE FOREIGN EXCHANGE (FX)1
Reference No.
TO:
(Name of AAB/AAB forex corp)
(Address)
I hereby apply to purchase FX with the following details:
APPLICANT DETAILS: Individual Corporate/Other Entity
(please check appropriate box)
Name :
Address :
Tel. No./Fax No./Email Address :
Tax Identification No. :
Valid Government ID Presented :
ID No. :
Residency : Resident Non-resident
(please check appropriate box)
FX to be purchased :
Amount (In Words) :
(In Figures) :
PURPOSE: (please check appropriate box/es)
Foreign loans/borrowings Trade (payment for importations)
(Debt Account No: ____________________) Resident to resident transactions
❑ Owed to Non-residents (other than OBUs) ❑ Obligations to residents
❑ Owed to Offshore Banking Units in the Philippines ❑ Investments in instruments (including time
❑ Prepayment deposits with at least 90-day maturity with
❑ Regular Payment onshore banks but excluding other bank
❑ Principal _____________________________ deposits such as savings and demand) that are
❑ Interest _____________________________ issued by other residents
❑ Fees _____________________________ Please specify: _____________________________
Inward Investments by Non-Residents ❑ Foreign currency loans owed to banks operating
❑ Repatriation of capital in the Philippines (FCDU/EFCDU/RBU)
❑ Remittance of earnings ❑ Prepayment
❑ Remittance in equivalent FX of excess pesos (funded ❑ Regular Payment
by inward remittance of FX) from unrealized ❑ Principal __________________________
investments in the Philippines ❑ Interest __________________________
❑ Settlement of FX obligations/payables of ❑ Fees __________________________
residents to non-resident investors relative to ❑ Others (Please specify): ______________________
FX-denominated equity and debt securities issued Non-trade current account transactions
by residents that are not partaking the nature of a ❑ Services
foreign loan Please specify2: ____________________________
❑ Remittance in equivalent FX of peso proceeds from ❑ Non-merchandise Insurance
onshore sale by non-resident issuers of their equity ❑ Premium
and debt securities ❑ Claims/payables
Outward Investments by Residents ❑ Travel Expenses
Total FX purchases for the current calendar year: ______
❑ Commissions
❑ Equity securities
❑ Professional/Management Fees
❑ not listed at an exchange
❑ listed at an exchange ❑ Royalties
❑ Debt securities ❑ Income3
❑ Offshore Mutual Funds (MFs)/Unit Investment Trust ❑ Refund of unused grants/donations
Funds (UITFs) ❑ Others (Please specify): ______________________
❑ Intercompany loan between/among related parties Others
❑ Purchase of real property abroad, such as ❑ Conversion to FX of peso deposit accounts of
condominium units and those for/under non-residents
construction ❑ Others (Please specify): ______________________
❑ Instruments issued onshore by non-residents
requiring settlement in foreign currency
❑ Others (Please specify): _________________________
1
To be accomplished for each purpose to which FX shall be purchased from AABs/AAB forex corps. Duly accomplished
Application Form, as well as supporting documents for sale of FX by AABs/AAB forex corps, may be submitted in
accordance with Part One, Chapter I of the FX Manual. AABs/AAB forex corps shall make available the original/copy
of documents (as applicable) upon request by the BSP for verification.
2
Such as Communications, Manufacturing, Maintenance and Repairs, Postal and Courier, Computer and Information,
Research and Development, Advertising, Market Research, Technical, and Other Business Services
3
Other than those related to loans and investments
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ANNEX A
(As amended by Circular Nos. 698 dated 5 Nov 2010, 794 dated 18 Apr 2013, 925 dated 13 Sep 2016,
984 dated 22 Dec 2017, 1030 dated 5 Feb 2019 and 1124 dated 10 Aug 2021)
FX DISPOSITION: (please check appropriate box)
FOR DIRECT REMITTANCE FOR CREDIT TO FCDU ACCOUNT TO BE HELD IN CASH
❑ In Full ❑ In Full (Only for FX sold for travel and
Amount: _______________ Amount: _______________ medical expenses abroad not yet
❑ Partial ❑ Partial incurred, and sales proceeds of
Amount: _______________ Amount: _______________ emigrant’s domestic assets where
Name of Account Owner: the emigrant is still in the
____________________________ Philippines)
Account No.: ❑ In Full
____________________________ Amount: _________________
Name of Depository AAB: ❑ Partial
____________________________ Amount: _________________
For eventual remittance on or
before: ______________________
INTENDED BENEFICIARY OF FX REMITTANCE: (Required to be filled out except for cases to be held in cash)
Name : ________________________________________________________________________________
Address : ________________________________________________________________________________
I hereby certify that:
a. No double purchase of FX has been made, whether on spot basis and/or via derivatives contracts
covering the same underlying transaction/s;
b. The FX purchased shall be used for the declared purpose;
c. For FX purchased that are credited to the FCDU account:
(i) The FX purchased shall eventually be remitted to the declared intended beneficiary, on or before
due date; and
(ii) In the case of investments in instruments under Sections 33.1 (foreign direct investment) and
33.3.a.i (equity securities not listed at an onshore exchange), crediting of FX to the FCDU account
of the non-resident investor’s resident agent/authorized representative is duly authorized by the
non-resident investor, and the FX shall eventually be remitted to the non-resident investor/
intended beneficiary, unless to be reinvested onshore by the non-resident;
d. As FX purchaser, I will disclose in the remittance instruction to the remitting bank the intended
purpose of remittance;
e. FX purchases shall not be made to circumvent regulations on FX transactions;
f. This Application Form and the supporting documents submitted via official channel (whether in
hardcopy or via electronic/digital means) are genuine, credible and not tampered;
g. All applicable laws, rules and regulations covering the declared FX transaction/s are complied/shall
be complied with;
h. Pertinent documents shall be made available upon request by the BSP for verification; and
i. The information disclosed in this Application Form are, to the best of my/our knowledge and belief,
complete, true and correct, and that the declaration is made in good faith. Said information may be
used by the FX selling institution and disclosed to the BSP for their intended purpose, subject to
pertinent laws, rules and regulations.
__________________________________________ _____________________________________________
Date of Application (DD-MMM-YYYY) Signature Over Printed Name
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