REQUEST FOR LOAN AVAILMENT FORM

Employee Name:

Department:

Requested Loan Amount: Approved Amt:

Loan Repayment Period: Approved Repayment Period:

Preferred Date of Release: Approved Loan Release Date:

Reason for Loan Request:

Requested by: Approved by:

___________________________ Ma. Jasmin Cielo A. Lopez

Corporate Treasurer

Date _____________________ Date ________________________

Noel Joseph V. Lopez

President

Date: ________________________