CREDIT APPLICATION

(For Individuals / Sole Proprietorship)

Supplier

Referred By (Salesman/Agent)

Branch

Application No.

Item Applied For

Cash Price

Amount Financed

Term

Age

Birthdate (MM/DD/YY)

Education
Post Graduate
College
Under Graduate

No of Dependents

Rented, How Much?

Own - Mortgage, With
Living with Relatives
Used Free
Length of Stay

____________________
____________________

GuarantyDep./Downpayment

AOR

APPLICANT
Last Name

First Name

Nationality

Civil Status
Single
Married

Middle Name

Widow/Widower
Separated

Home Address

_____Yrs.

_____Mos.

Provincial Address
Tel. No. 1

Tel. No. 2

Last Name

First Name

Mobile No.

E-mail

SPOUSE / CO-MAKER INFORMATION

Middle Name
Age

Birthdate (MM/DD/YY)

Home Address

EMPLOYMENT
PRINCIPAL
Business Address

Name of Employer/Business

Employment Status
Employed
Self Employed

Tel. No. 1
OFW
Others ___________

Tel. No. 2

Position

Tel. No. 2

Position

No. of Years with Company:

CO-MAKER
Business Address

Name of Employer/Business
Employment Status
Employed
Self Employed

Tel. No. 1
OFW
Others ___________

No. of Years with Company :

NET INCOME
Monthly Salary :
Spouse's Monthly Salary :
Other Monthly Income From :

Total Monthly Income

PERSONAL & CREDIT REFERENCES

Name of Children/Dependents

Credit References

Address & Tel. No/s.

Age

School

Acct No.

Loan Type

SAVINGS ACCOUNT/S AT :
Bank / Branch
1)
2)

Account Number

CURRENT ACCOUNT/S AT :
Bank / Branch
1)
2)

Account Number

TIME DEPOSIT/S AT :
Bank / Branch
1)
2)

Account Number

Grade Level

Mo. Amort

O/S Balance