VEHICLE / LOAN INFORMATION

Vehicle Selling Price Amount for Financing

Php Php

Sales Executive Down Payment Terms

Chams Florendo Php % in months

BORROWER’S INFORMATION CO-BORROWER’S INFORMATION

Last Name / First Name / Middle Name Nick Name
Last Name / First Name / Middle Name Nick Nam

Birth Date Birth Date Relation to Borrower

Residence Address Residence Address

[ ] Owned – Mortgaged [ ] Company Provided [ ] Owned – Mortgaged [ ] Company Provided

[ ] Owned – Not Mortgaged [ ] Rented [ ] Owned – Not Mortgaged [ ] Rented
[ ] Living with Family Length of Stay [ ] Living with Family Length of Stay
Residence Telephone Number Mobile Number Residence Telephone Number Mobile Number

Email Address Facebook Account Email Address Facebook Account

Civil Status Gender Civil Status Gender

[ ] Single [ ] Widowed [ ] Separated [ ] Male [ ] Single [ ] Widowed [ ] Separated [ ] Male
[ ] Married [ ] Common-Law Marriage [ ] Female [ ] Married [ ] Common-Law Marriage [ ] Female
Citizenship No. of Dependents Tax ID Number Citizenship No. of Dependents Tax ID Number

Employer’s / Business’s Name Office Number Employer’s / Business’s Name Office Number

Office Address Office Address

Position Length of Stay Position Length of Stay

Employment Type Monthly Income Employment Type Monthly Income

[ ] Salaried [ ] Self-employed [ ] OFW Php [ ] Salaried [ ] Self-employed [ ] OFW Php
Nature of Business Nature of Business
Previous Employment Length of Stay Previous Employment Length of Stay

ADDITIONAL INFORMATION FOR SELF-EMPLOYED

Major Customers Contact Number Major Suppliers Contact Number

BANK ACCOUNTS CREDIT CARDS OWNED

Bank / Branch Type of Account Account Number Card Company Credit Limit Expiry Date

_______________________________________________________________ _______________________________________________________________
Borrower’s Signature Over Printed Name / Date Co-Borrower’s Signature Over Printed Name / Date