Type of Kabuhayan Loan Applied

/___/ TERM
/___/ LINE
/___/ FRANCHISE
Loan Purpose:
Amount Applied for: P
Term:
FRANCHISOR INFORMATION (For Franchise loan applicants only)
Name of Franchisor:
Nature of Franchise:
Accreditation: /___/ PFA
/___/ AFFI
/___/ FIFA
/___/ OTHERS (Pls. specify)
Year Established:
Collateral Offered (if REM)
Description

TCT / CCT No.

Registered Owner

1x1

Location

Market Value
P

Collateral Offered (if Deposits)

TD Account Number

Account Name

Applicant's Information /___/ Main Borrower /___/ Co-borrower

Full Name
Present Address (If Applicable)
Years of stay: _______ Yrs.
/___/ Owned /___/ Owned - Mortgaged
Residential Address
Years of stay: _______ Yrs.
/___/ Owned /___/ Owned - Mortgaged
Previous Address (If Applicable)
Years of stay: _______ Yrs.
/___/ Owned /___/ Owned - Mortgaged
Landline Number / s
Mobile Number / s
Email Address
Nationality
Date of Birth
Highest Educ. Attainment, Degree, School
Civil Status
Name/s of children, age (If applicable)
Main Source of Income

Maintaining Branch

Applicant

Amount

Spouse

/___/ Rented P______/mo /___/ Living w/ relatives

/___/ Rented P______/mo /___/ Living w/ relatives
/___/ Rented P______/mo /___/ Living w/ relatives

(e.g. business,
employment, pension,

Work & Occupation (If employed)

Present Employer:
Nature of Business:
Address:
Phone Number:
Previous Employer:
Nature of Business:
Address:
Phone Number:
Business Information (with Business)
Name of Business:
Nature of Business:
Address:
Phone Number:
Location of Primary Business:
Yrs. occupied _____ /___/ Owned /___/ Owned - Mortgaged /___/ Rented P______/mo /___/ Others _____________
Products or Service offered:

Yrs.in service:
Position/Dept:
Yrs.in service:
Position/Dept:

_______Yrs
_______Yrs

Years in Bus. Operation:

Registered with:
Location of branches (if any):

Top 5 Customers (if applicable)

Contact Person & Number

Service/ Product Sold

Top 5 Suppliers (if applicable)

Contact Person & Number

Service/Product Purchased

Estimated Monthly Income

Remarks

Other Source of Income (if applicable):

Source of Income

Professional & Personal References (Except parents, siblings or other relative/s)

Name
Address

Phone Number

Relationship

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Financial References
Loans (If Applicable)
Name of Lender

Credit Cards (If Applicable)

Card Issuer

Deposits
Name of Bank

Type of Loan

Collateral

Card Number

Contact/Phone No.

Final Maturity

Monthy Amrtn

Balance

Expity Date

Credit Limit

Balance

Type of Account

Account Number

ADB

Authorization and Undertaking

The applicant warrants that all the information and documents given or heretofore given to the Bank for and in connection with the Credit Facility/ies applied for
are true and correct in all material respect. In this connection, the Applicant hereby waives the confidentiality of information on the foregoing documents and
grants to the Bank the authority (i) to verify with the BIR and/or other government agencies and/or private persons and entities the authenticity thereof, and (ii) to
use and disclose any information contained in the foregoing documents in connection with any transaction involving or pertaining to the Credit Facility/ies. For
this purpose, the Applicant shall indemnify and shall save the Bank free and harmless from any claims, damages or liabilities of whatever kind and nature that
may arise in connection with the use or disclosure of any confidential information given by the Applicant to the Bank to support this application.
Signature
Name of Applicant
Documents Check-Off List

Date Submitted
Received by/Branch
Pls submit items
w/Check Mark

Docs.validated
by (signature)

For those with a Business

a.
Copy of Income Tax Returns (ITRs) & Audited FS of the Business for the last 3 consecutive years
/___________/
b.
DTI Certificate of Business Name Registration for sole proprietorship / SEC Papers for partnership & corp.
/___________/
c.
Business Permit
/___________/
d.
Bank statements for the last 6 consecutive months
/___________/
e.
Photocopy of any 2 valid ID's with photo & signature (I.e. passport, license, company ID,..)
/___________/
f.
Copy of marriage contract (if applicable)
/___________/
g.
Copy of franchise endorsement / contract with franchise owner (for franchise loan)
/___________/
h.
Financial projections (for franchise loan)
/___________/
i.
List of Customers and Suppliers with contact details
/___________/
2.
For other sources of Repayment (i.e. Employment, Rentals etc. )
a.
Copy of personal Income Tax Returns (ITRs) for the last 3 consecutive years
/___________/
b.
Latest Certificate of Employment indicating position,tenure (if any)
/___________/
c.
Copy of payslip for the past three (3) consecutive months (if any)
/___________/
d.
Bank statements for the last 6 consecutive months
/___________/
f.
Photocopy of any 2 valid ID's with photo & signature (I.e. passport, license, company ID,..)
/___________/
g.
Copy of marriage contract (if applicable)
/___________/
h.
Copy of franchise endorsement / contract with franchise owner (for franchise loan)
/___________/
i.
Financial projections (for franchise loan)
/___________/
j.
List of Tenants with monthly lease amount/Lease Contracts (if applicable)
/___________/
k.
Other proof of income (i.e. remittances, commission slips, etc.)(if applicable)
/___________/
3.
Collateral Documents
a.
Copy of TCT/CCT, updated Tax Dec. & RETR's
/___________/
b.
Vicinity map/location plan/lot plan
/___________/
c.
Master Deed of Restriction (for Condo's)
/___________/
d.
Collateral Appraisal Authorization
/___________/
e.
Copy of deposit instrument
/___________/
Note: Photocopies will be acceptable provided original copies are brought to the branch/business center for proper validation

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