VEHICLE TO BE PURCHASED

Unit/Model Selling Price

Php -
Amount For Financing
Php -
Dealer/Agent
Florefel Dawis - 497-0209 / 0922-7909308
Down Payment
Php -%
Terms
in months
BORROWER S INFORMATION
Name (Last Name / First Name / Middle Name) Nick Name Date of Birth Place of Bir
th
Civil Status No. of Years No. of Dependents Mother s Maiden Name Citizenship
Present Home Address
Years of Residency Telephone Number/s Cell Phone Number/s Email Address
Previous Address (if residency is less than 2 years)
Employment / Occupation EMPLOYED SELF-EMPLOYED / BUSINESS
Employer s / Business Name
Office / Business Address
Telephone Number/s
Position
Years in Employment / Business
Monthly Income
Tax Identification Number Previous Employer (if less than 2 years in current emp
loyment) Nature of Business DTI Registration No.
SPOUSE / CO BORROWER S INFORMATION
Name (Last Name / First Name / Middle Name) Nick Name Date of Birth Place of Bir
th
Employment / Occupation EMPLOYED SELF-EMPLOYED / BUSINESS
Employer s / Business Name
Office / Business Address
Telephone Number/s
Position
Years in Employment / Business
Monthly Income
Tax Identification Number Previous Employer (if less than 2 years in current emp
loyment) Nature of Business DTI Registration No.
BANK ACCOUNTS CREDIT CARD OWNED
Bank/Branch Type of Account Account No. Card Company Credit Limit Expiry Date
TRADE AND BUSINESS REFERENCES
Name Contact Person Telephone No. Nature of Transaction / Volume
AGREEMENT
I/We affirm that each of the statements made in this application is true and cor
rect and the signatures appearing herein are genuine. I/We agree to notify the B
ank of any
changes affecting the information contained herein. I/We authorize the Bank to o
btain and verify such information as many be required covering this application
from the
above references or any other sources. For this purpose. I/We hereby waive my/ou
r rights in the confidentiality of client information. A photocopy of this autho
rization shall be
effective and valid as the original. I/We agree that any information obtained by
the Bank shall remain its property whether or not the loan is granted.
I/We confirm that I/we do not have any relative within the first degree of consa
nguinity or affinity working in the Bank. I/We agree that this loan application
shall be subject to
Bangko Sentral ng Pilipinas regulations including those pertaining to directors,
officers, stockholders and related interests of the Bank. I/We further agree an
d understand
that, should this application be denied, the Bank is not obliged to furnish the
reason for denial.
I/We fully understand that any material misrepresentation or failure to disclose
information on my/our part as required herein, may cause disapproval of my/our
loan
application; and the Bank at any time, shall have the right to cancel the loan a
pproval and/or declare the loan due demandable.
_________________________________________________
Borrower s Signature Over Printed Name / Date
_________________________________________________
Spouse s/Co-Borrower s Signature Over Printed Name / Date
VEHICLE TO BE PURCHASED
Unit/Model Selling Price
Php -
Amount For Financing
Php -
Dealer/Agent
Florefel Dawis - 497-0209 / 0922-7909308
Down Payment
Php -%
Terms
in months
BORROWER S INFORMATION
Name (Last Name / First Name / Middle Name) Nick Name Date of Birth Place of Bir
th
Civil Status No. of Years No. of Dependents Mother s Maiden Name Citizenship
Present Home Address
Years of Residency Telephone Number/s Cell Phone Number/s Email Address
Previous Address (if residency is less than 2 years)
Employment / Occupation EMPLOYED SELF-EMPLOYED / BUSINESS
Employer s / Business Name
Office / Business Address
Telephone Number/s
Position
Years in Employment / Business
Monthly Income
Tax Identification Number Previous Employer (if less than 2 years in current emp
loyment) Nature of Business DTI Registration No.
SPOUSE / CO BORROWER S INFORMATION
Name (Last Name / First Name / Middle Name) Nick Name Date of Birth Place of Bir
th
Employment / Occupation EMPLOYED SELF-EMPLOYED / BUSINESS
Employer s / Business Name
Office / Business Address
Telephone Number/s
Position
Years in Employment / Business
Monthly Income
Tax Identification Number Previous Employer (if less than 2 years in current emp
loyment) Nature of Business DTI Registration No.
BANK ACCOUNTS CREDIT CARD OWNED
Bank/Branch Type of Account Account No. Card Company Credit Limit Expiry Date
TRADE AND BUSINESS REFERENCES
Name Contact Person Telephone No. Nature of Transaction / Volume
AGREEMENT
I/We affirm that each of the statements made in this application is true and cor
rect and the signatures appearing herein are genuine. I/We agree to notify the B
ank of any
changes affecting the information contained herein. I/We authorize the Bank to o
btain and verify such information as many be required covering this application
from the
above references or any other sources. For this purpose. I/We hereby waive my/ou
r rights in the confidentiality of client information. A photocopy of this autho
rization shall be
effective and valid as the original. I/We agree that any information obtained by
the Bank shall remain its property whether or not the loan is granted.
I/We confirm that I/we do not have any relative within the first degree of consa
nguinity or affinity working in the Bank. I/We agree that this loan application
shall be subject to
Bangko Sentral ng Pilipinas regulations including those pertaining to directors,
officers, stockholders and related interests of the Bank. I/We further agree an
d understand
that, should this application be denied, the Bank is not obliged to furnish the
reason for denial.
I/We fully understand that any material misrepresentation or failure to disclose
information on my/our part as required herein, may cause disapproval of my/our
loan
application; and the Bank at any time, shall have the right to cancel the loan a
pproval and/or declare the loan due demandable.
_________________________________________________
Borrower s Signature Over Printed Name / Date
_________________________________________________
Spouse s/Co-Borrower s Signature Over Printed Name / Date