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Bond Application Form
GSIS application form for bond
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_____________________
, 2010
GOVERNMENT SERVICE INSURANCE SYSTEM
GSIS Bldg., Financial Center, Roxas Blvd.,
Pasay City, Metro Manila
ATTENTION: SURETYSHIP DIVISION
This is to Certify that the (position held in the corporation) .
and/ or
__________
of the (name of corporation)
;;_
AUTHORIZED Mr./Ms
and/or Mr./Ms.
_
to sign for and in behalf of the corporation all bonds to be obtained from the GSIS and indemnity
agreements and other papers that may be required by the GSIS for the issuance of such bonds.
This authority shall remain in full force and effect and bonding against the corporation until
revoked and until such revocation has been given and received by the Suretyship Division, GSIS.
As per Board Resolution No.
dated
~
_
(Name and Signature)
Board/Corporate Secretary
SUBSCRIBED AND SWORN to before me this
at
affiant exhibited to me his/her Res. Cert, No.
issued at
on
_
Doc. No.
Page No.
Book No.
Series of
_
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_
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SPECIMEN SIGNATURE OF DESIGNATED
(Name and Signature)
Res. Cert. No.
_
Issued at ---------On
_
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--,-
NOTARY PUBLIC
OFFICIALS:
(Name and Signature)
Res. Cert. No.
Issued at
On
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