Since 1967 Member-Loan Applicant Information: Name Membership Number AL Gender Membership Type Main Occupation TAGUM COOPERATIVE (3 “ashore people invest ther bust” LOAN APPLICATION FORM Mbr-Application No. Date application (Please fill up this form completely) Share Capital P ‘Age of Member __ Birthdate Civil Status Status of Residence [_Jowned [_]rented [_]others: specify Educational Level Credit Rating * Other Information * To be filled up by the officer Family of Applicant: Name of Spouse Occupation of Spouse ‘Address/Contact, Information: Street District/Brgy. City/Town Membership Number lephone No. Mobile Phone No. Number of Children: Email Address Fax Number [Jin Elementary [In High School [Jin College [_]Ete Employment Type ‘Type of Business Type of Profession Job Title/Position Name/Desc. Address Employer Address, T= | Telephone. Addre: Telephone. Monthly Revenue: ‘Telephone Monthly Expenses Monthly Expenses 3 Date Employed Monthly Income. Monthly Income Monthly Salary Date Started Date Started ‘i Other Source of Income =) Other Sources of Income ‘Member's Assets (inn peso): Value of Residence Business Assets Assets in Profession Real Estate Property Vehicles Owned Bank Deposits Financial Investment Other Valuables Total Assets Financial Referenc ‘Member's Liabilities: Current TC Loans External Bank Loans Financing Companies Credit Cards Other Debt Total Liabilities Member's Net Worth: Assets- Liabilities. Personal References: UNDERTAKING 1 the loan applicant on record, together with my Cooperative under the following teks dnd cond Loan Type Loan Purpose Mode of Payment this regard, I hereby authorize Tagum Coop conduct any credit investigation on my person: jan presented jim made with this application Member’ Signature is form are true aid correct to the best of my knowledge. underst Go-signers, wish to aval ofa loan from tl Loan Amount Loan ‘Term in Months — Interest Rate per Month ive and its duly designated representative(s) 10 that it may deem necessary: I hereby certify that all id shall be sufficient basis for its disapproval. Spouse Signature Members Incomeand Eaxpems Monthly. Income: Salary Business Profession Monthly Pension Monthly Commissions Investment Income Spouse Income Total Income Monthly Expenses: Basic Eamily- Expenses Food Expenses Education Utes i Was BB) ‘Transportation Bin TC Loan Payments Bank Loan Payments Finance Co, Payments Credit card Payments Other Debt Payments Other Expenses Housing Vehicle Fuel/Maint Other Expenses Assigned to Spouse Total Expenses Net Income/Savings: Valid Kdentifcation No Issued by Issued on Valid uni TIN APPLICANT SPOUSE“ushere people invest thet burst” Since 1967 Member-Co-Maker Information: Share Capital P Name Age of Member Membership Number Birthdate, Membership ‘Type Gender Main Occupation Civil Status Status of Residence [_]owned[_] rented [_]others: specify TAGUM COOPERATIVE (5 Mbr- Application No. Date ofsApplication (Please fill up this form completely) Educational Level Credit Rating * Other Information * To be filled up by the loan officer Address/Contact Information’ Name of Spouse Street Address Membership Type. District/Brgy. City/Town, Occupation of Spouse ‘Telephone No. Fax Number ‘Number of Children: Email Address, Mobile Phone No. (Jin Elementary [_]In High School [7}In College [7] Ete. Employment Business: Pieeainn| Type —_ it Type of Business ais 1 | Type of Profession Job Title/Position ts ) Name/Desc. ct | Address Employer Address Teepe Address______uavail vidiaadé| ‘Telephone. Mathie eenic Telephone sssssust ust) Monthly Expenses = | Monthly Expenses Date Employed sist sidan) Monthly Income aacsciviiaal’ |Monthly Income Monthly Salary Date Started Date Started Other Info 2 Other Info. Member's Assets (in peso): > Member's Liabilities: Member's Income and Expenses: Value of Residence Current TC Loans ‘Monthly Income: Business Assets External Bank Loans St Salary Assets in Profession Financing Companies Business Real Estate Property Credit Cards Profession Vehicles Owned Other Debt Monthly Pension Bank Deposits Total Liabilities Monthly Commissions eo) Financial Investment Investment Income Other Valuables: Member's Net Worth: Spouse Income 2oldguleV rors Total Assets Assets-Liabilities RESIDENCE LOCATION SKETCH ‘CO-Maker Signature ‘Co: Maker’ Spouse Signature APPLICANT Valid Wlentification No Issued by Issued on Valid wail TIN ‘otal Income mnthly Expens Basic Family Expenses Food Expenses Education Unites (hs: a i ‘Transportation TC Loan Payments Bank Loan Payments Finance Co. Payments Credit card Payments Other Debt Payments Other Expenses Housing Vehicle Fuel/Maint Other Expenses Assigned to Spouse Total Expenses Net Income/Savings: SPOUSE