BARBAZA MULTI-PURPOSE COOPERATIVE

Barbaza, Antique

LOAN APPLICATION

LOAN APPLIED FOR: (__) Instant Loan (__) Regular Loan (__) Faxcom Loan (__) Salary Loan (__) BACAP
(__) MEDAP (__) STL (__) Others (Specify) ________________________
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I hereby apply for a loan of ___________________________ PESOS for a period of ______ months, to be repaid in monthly
installments of _______________________ (P_________) Pesos plus interests; I prefer the first payment to fall due on
___________________.

I desire this loan for the following purpose: __________________________________________________________________

Security offered: (__) Share Capital (__) Savings/Time Deposits (__) Co-maker/s (__) Collateral

I/We hereby certify that all statements made including those on reverse side hereon are true and complete and submitted for
the purpose of obtaining credit this ____ day of _______________________.

___________________________ ____________________________ ________________________________

Name of Member-Borrower Signature Address
___________________________ ____________________________ ________________________________
Name of Co-Maker Signature Address
___________________________ ____________________________ ________________________________
Name of Co-Maker Signature Address
To be filled up by the Loan Officer/Technical Assistant
This is to certify that the Maker and Co-maker(s) of this loan application have the following share capital, savings/time deposits
and obligations with this Cooperative.

____________________________ __________________ ________________ ______________________________

Maker Share Capital S/T Deposits Current Loan
____________________________ __________________ ________________ ______________________________
Co-Maker Share Capital S/T Deposits Current Loan
____________________________ __________________ ________________ ______________________________
Co-Maker Share Capital S/T Deposits Current Loan
____________________________
Loan Officer/TA
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APPLICANT’S STATEMENT

Occupation: Monthly Income:

Employer (If employed) Address:
Monthly Salary: P Status: pls.check Permanent Contractual Temporary
Spouse Name: No. of Dependent/s:
Is spouse employed? Monthly Salary:
Real property owned: Market Value:
Location: Phone Number:
References:

CO-MAKER’S STATEMENT

Name of Co-Maker Address

Employer (if employed) Address
Position Monthly Salary
Spouse Name No. of Dependents
Real property owned Market Value
Location Phone No.
References

Name of Co-Maker Address

Employer (if employed) Address
Position Monthly Salary
Spouse Name No. of Dependents
Real property owned Market Value
Location Phone No.
References

At a meeting held on ___________________, we approved the loan in the amount of ________________________________

(P__________) and on the conditions agreed on with the applicant. The Committee’s action is recorded in the minutes of
_____________________________.

_______________________________________________ Manager

_______________________________________________

_______________________________________________ } In-House Committee

Credit Committee