Form No.

OP-004, Revised 092013 APPLICATION FOR LOAN PRESENT LATEST PAY SLIP
(Supersedes Form No. OP-004, Revised 032012) EVERY LOAN APPLICATION

MANILA TEACHERS’ Date: …………….……………..

918 United Nations Avenue, Ermita, Manila
(Please fill up all spaces with check / No erasures)
Gentlemen:
The undersigned member of this Association desires to avail of its loan facilities for a loan of ………………
……………....................................................................................Pesos (P ……..…..……….) which shall be paid in equal monthly
installments for a period of ….……. months.
PURPOSE: Education Medical Agricultural Home Building & Development Personal Finance
Others, Pls. Specify: .......................................................................
TERMS AND CONDITIONS:
1. The interest on this loan and other charges shall be added on to the loan granted subject to the provisions of existing laws
and regulations.
2. The payment of this loan shall be through salary deduction and the undersigned member-borrower agrees and hereby
authorizes the Payroll Service Division of the DepEd or Paymaster to deduct said amount from the borrower’s salary and
other compensation.
3. The member-borrower certifies that he/she has not taken the commuted value of his/her vacation and sick leave credits
for the period covered for the payment of this loan and that the net salary due him/her during the said period is enough to
cover the installment payments on their respective due dates. In case of default, the member-borrower agrees that his/her
deposits and capital contributions with the Association shall be debited to the extent of the amount due, and that no
withdrawal from these shall be made until such loan is fully paid.
4. In case of non-payment for three (3) consecutive installments, the Association reserves the right to consider the entire
balance of the loan due and demandable, notwithstanding the imposition of applicable penalties, in accordance with
existing policies of the Association on delinquent accounts.
5. The co-makers shall, in case of inability of the member-borrower to satisfy this obligation, be jointly and severally liable
for the same. The co-makers further agree that their deposits and capital contributions with the Association or in any of
its affiliate companies shall be pledged and/or assigned to the balance of the loan and shall be debited to the extent of this
obligation.
6. Borrower agrees to allow the Association to assign or transfer the loan in whole or in part to any person or entity and for
this purpose authorizes said assignee/transferee to collect payment through deductions from borrower’s salary and other
compensation. He/she authorizes the Association to apply any residual fund for the payment of his/her other obligation
in favor of the Association or any of its affiliate company.
7. Additional fees and penalties may be applied in accordance with the existing policies of the Association. Further,
borrower agrees to abide with the Association’s rules, policies and arrangements made at the Principal Office as deemed
necessary in order to collect the loan and other obligations.

MAKER OR BORROWER: ………………………………………………………. …………………………………........

Age: ………………. (Print Name) (Signature)
Employment Status: …………….……………………. Monthly Salary: P …………..…………………………...
School: ……………………………………………….. Div.# ……….. Sta. # ……… Emp.# ..…………

DISCLOSURE STATEMENT ON LOAN

(As Required Under R.A. 3765, Truth in Lending Act)

………..LOAN GRANTED P ……………… : Approved by: __________________________

(Principal Amount) Signature of Approving Manager
Add Charges: :
Finance Charges : Percentage of Finance Charges to
Interest ………….... : Loan Granted ……….…..%
Service and Collection Fee …………... ………..……. :
Non-Finance Charges ……………… :
Total Loan ……………… :
Less: Old Loan Balance/PDL Interest ……………… :
Add Others ……………... :

NET PROCEEDS OF LOAN P ……………… :

Effective Interest Rate is ____________%

I ACKNOWLEDGE RECEIPT of a copy of this statement prior to the consummation of the credit transaction and that I
UNDERSTAND AND FULLY AGREE to the terms and conditions thereof.

……………………………………………… ………………………………
MEMBER/BORROWER Date Signed
(Print Name and Sign Above)
( RECEIPT )

RECEIVED this ……... day of …………………………, 20…… Check No. ………........... representing the proceeds of my
loan with the above named Association as evidenced by Promissory Note No. …………. dated …………………………, 20…… for
a …………………………….. loan of …………..……………......................................…………..………Pesos (P ……..……..………)
CONTROL NO. …………………
DIV. NO. ……… STA. NO. ……… EMP. NO. ………..……

……………………………………………………
MEMBER/ BORROWER
(Print Name & Sign Above)
MANILA TEACHERS’ Please fill up all spaces with check
918 United Nations Avenue, Ermita, 1000 Manila
Tel. Nos. 404-2790 to 95; Fax No. 525-3833 NO ERASURES

PROMISSORY NOTE

AMOUNT OF PROMISSORY NOTE: P …………………………………….. DATE: ……………………………...

DUE DATE OF LOAN: ……………………………………………………….

FOR THE VALUE RECEIVED, I/WE jointly and severally promise to pay Manila Teachers’

or order the SUM OF ………………………...……………..……………..……………………. PESOS (P ………....……….), with interest

at the rate of ………………..… ( %) PERCENT PER ANNUM, payable on or before …………………………….., 20 ………
I, as Maker/Borrower, further pledge my capital contributions and deposits against the loan and shall not withdraw any amount until
this is fully paid.
We, as Co-Makers, further agree that our capital contributions and deposits maintained with the Association or on any of its affiliate
companies shall be pledged to the balance of the loan and shall be debited to the extent of the unpaid obligation as required by the terms and
conditions of this loan.
In case of non-payment for three (3) consecutive installments, the Association reserves the right to consider the entire balance of the
loan due and demandable, notwithstanding the imposition of applicable penalties, in accordance with existing policies of the Association on
delinquent accounts.
In the event this notice is placed in the hands of an attorney for collection, I/We , as the Maker and the Co-Makers shall pay the
TEN PERCENT (10%) of the amount due on the note as Attorney’s fee and expenses for litigation, which in no case shall be less than one
thousand pesos (P1,000.00).

MAKER OR BORROWER: …………………………………………………………… …………………………................

(Print Name) (Signature)

Home Address (COMPLETE) …………………………………………………………………………………………………………………

Government/School ID & No.: …………………………...………….……..Valid Thru (if with validity, pls indicate): ……………………

……………………………………………………………… ………………………………………………………............
CO-MAKER CO-MAKER
(Print Name and Sign Above) (Print Name and Sign Above)

Government/School ID & No. …………………….……… Government/School ID & No. ………….………….……

Valid Thru (if with validity, pls indicate): ………………..……. Valid Thru (if with validity, pls indicate): ………………………

Home Address (COMPLETE) ……………………………. Home Address (COMPLETE) ……………………………

……………………………………………………………..... ……………………………………………………………........

Div. ……….. Sta. ……… Emp. No. …………….….. Div. ……… Sta. ………… Emp. No. ………………

DATE SIGNED …………………………………………… DATE SIGNED ……………………………………………

……………………………………………………………… ………………………………………………………............
CO-MAKER CO-MAKER
(Print Name and Sign Above) (Print Name and Sign Above)

Government/School ID & No. …………………….……… Government/School ID & No. ………….………….……

Valid Thru (if with validity, pls indicate): ………………..……. Valid Thru (if with validity, pls indicate): ………………………

Home Address (COMPLETE) ……………………………. Home Address (COMPLETE) ……………………………

……………………………………………………………..... ……………………………………………………………........

Div. ……….. Sta. ……… Emp. No. …………….….. Div. ……… Sta. ………… Emp. No. ………………

DATE SIGNED …………………………………………… DATE SIGNED ……………………………………………

CERTIFICATION FOR CURRENT EMPLOYMENT (To be filled up by Principal/Asst. Principal/Head Teacher)

……………………………………………
Date
TO WHOM IT MAY CONCERN:
This is to certify that …………………………………………………………………, a permanent teacher/employee in this school
is not presently on leave or intending to go on leave of absence this current school year.
This certification is made in connection with his/her application for a salary loan with Manila Teachers’

HE/SHE HAS NO PLANS TO RESIGN/ ……………………………………………………………

RETIRE DURING THE NEXT 12 MONTHS School Principal/Assistant Principal/Head Teacher

VERIFICATION OF NET SALARY (To be filled up by Paymaster / Payroll Clerk)

……………………………………………
Date
Division No. …………. Station No. …………. Employee No. ….…………………
Net Salary for the month of ……………………… Amount P …………………
1st Quincena P …………… 2nd Quincena P ………………
……………………………………
PAYMASTER/PAYROLL CLERK