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Form 25 (Lower Court Member) Note: Attach Certified Xerox Copy of Pay Slip, Applicants ID

NOTE: USE BLUE INK & Endorsing Officers ID


This application can be reproduced by photocopying only, *Effective January 1, 2014 no other form shall be accepted except
Please do not re-type. For this Official Form.

SCSLA
SUPREME COURT SAVINGS & LOAN ASSOCIATION, INC.
Padre Faura, Ermita, Manila

LOAN APPLICATION
SALARY/MULTI PURPOSE/EDUCATIONAL
SAL Up to 4Mos.Salary; MUL Up to 100K; EDU Up to 44K

The Board of Directors Date_________________


SCSLA, Inc.
Manila
Gentlemen/Mesdames:

I have the honor to apply for a loan in the amount of


(P_____________), payable in ______ months in regular, weekly/ weekly/semi-monthly installments, beginning on , in
accordance with the stipulations contained in the herein promissory note.

OFFICE: __________________________ REGION ________


STATUS OF APPOINTMENT ________________ POSITION _______________ APPLICANTS SIGNATURE
EDP No. ___________________ ID NO. __________________________
COMPLETE ADDRESS: _____________________________________________
________ ______
APPLICANTS SIGNATURE

____________________
PRINTED NAME
ENDORSEMENT:
CERTIFICATION
Respectfully endorsing to the S C S L A this loan application and strongly recommending its approval. I certify that he/she and all
his/her sureties are permanent employees in the Court and in good standing and that all signatures appearing herein are genuine and
authentic. I further certify that he/she has no pending administrative and/or criminal case.

_______________________________ _____________ ___________


SIGNATURE OVER PRINTED NAME EDP NUMBER ID NUMBER
JUDGE OR CLERK OF COURT
MEMBERS DATA
STATUS OF SCSLA LOAN

KINDS OF LOAN AMOUNT OF DATE OF LOAN BALANCE WEEKLY/MONTHLY DEDUCTIONS


LOAN GRANTED as of ________ CURRENT NEW
SALARY LOAN P p p p
MULTY PURPOSE LOAN P p p p
EDUCATIONAL P p p p
ALLOWANCE LOAN P p p p
TOTAL DEDUCTIONS p
LEAVE CREDITS: TAKE HOME PAY PER EDP DEDUCTION p
TAKE HOME PAY AFTER SCLA DECUCTION p
AS OF MONTHLY SALARY p
VACATION LEAVE CAPITAL CONTRIBUTION p
SICK LEAVE
TOTAL Single Borrowers Limit (SBL) Computations:
By:
LEAVE/ADM. SERVICES Salary: Others:
Allowance:
CREDIT COMMITTEE Capital Con.: SBL:
Approved:

CONFIRM THAT THE ABOVE


BALANCES ARE CORRECT:

YOUR PAY SLIP SERVES AS YOUR SCSLA RECEIPT MEMBERS


SIGNATURE
---------------------------------------------------------------------------------------------
LOAN PREREQUISITES PER CB POLICIES APPROVED/CONFIRMED (TRUSTEES)
and RESOLUTIONS:
Permanent Appointment
Payment of 30% of outstanding loan
Not on leave without pay
Required take home pay
No default, delay or deficiency in loan payment
Equitable ratio of total obligations to capital contributions
August 2013 Edition

PROMISSORY NOTE
P , 20

FOR VALUE RECEIVED, I hereby promise to pay the SUPREME COURT SAVINGS & LOAN ASSOCIATION
(SCSLA) INC., or order, thru payroll deductions from my Judiciary Development Fund (JDF) Allowance, Mid-year/Year-end
bonuses and similar fringe benefits the amount of (P ), with
interest at the rate of percent(________) per annum in _________installments of P__________ each, payable
every payday, until this loan, including interest and other charges, shall have been fully paid. I hereby authorize the
Cashier/Disbursing Officer to deduct from my salary / RATA / JDF or similar allowance the said amount as may be due and
payable.

I hereby agree that in case of delay by thirty (30) days or more in the payment of my installment, or in case of war
breaks out, or likewise, in case of my death, disability, retirement, resignation, transfer, absence without leave, suspension,
separation from my present office, the entire unpaid balance of this loan, including interest and other charges shall
immediately become due and payable without need of any formal demand, and hereby agree to pay additional interest at the rate
of percent ( ) per annum on the total amount due until paid, payable and computed monthly.

In consideration of this loan, I hereby assign in favor of SCLA, so much of my Capital Deposits, including earned
dividends with SCSLA, and all monies and monetary benefits due or to be due from my present office, Government
Service and Insurance system and/or from any other government office or other source as well, sufficient to pay off the entire
outstanding balance of this loan, including stipulated interest, service charge and attorneys fee. I therefore authorize the office
concerned to deduct the aforementioned obligation(s) from all monies due me and to remit said monies directly to the SCSLA
thru its duly authorized representative(s). This assignment is irrevocable for as long as my obligation(s) with SCSLA remains
unpaid.

In case it shall become necessary to collect this note by and through attorney-at-law and/or in the event of court
litigation, I shall pay twenty (20%) percent of the amount due on the note as attorneys fee plus cost of suit. Any case arising
out of this transaction shall be brought in the city of Manila.

I hereby agree that the proceeds of this loan be insured in SCLAS Loan Redemption Insurance.

_______________________________
Applicants Signature

_______________________________
Applicants Signature

______________________
Applicants Printed Name
CO MAKERS UNDERSTANDING
In consideration of the above mentioned loan to the Principal, WE, the undersigned co-makers, bind ourselves jointly and severally
to pay in case of the principals default any and all amounts or which may be due hereinafter including interest, service charges and attorneys
fees in accordance with the terms and conditions of the above promissory note. In this connection, we hereby assign in favor of SCSLA so
much of our monies and monetary benefits due, or to be us, individually, from our present offices, Government Service Insurance System,
from any other government office and any other sources as is sufficient to pay the above loan. Upon default of payment of any installment, all
other installment shall become due and payable, jointly and severally agree to pay additional interest at the rate of per annum
of the total amount due until paid, payable when computed monthly. We therefore, authorize the office(s) concerned to deduct from all monies
due us, individually, the necessary amounts and to remit said monies directly to the SCSLA thru its duly authorized representative(s). This
authority to deduct and deed of assignment shall be irrevocable for as long as the above loan or any renewal there of remains unpaid.

WE SIGN AS CO-MAKERS:

PRINTED NAME SIGNATURE EDP/EMPLOYEE NO. ID NO. COURT/STATION


NOTE: CO-MAKERS MUST BE SCSLA MEMBERS. HOWEVER NON-MEMBERS WHO HAVE SIGNED AS CO-MAKERS
ARE STILL LIABLE AS SUCH.