INTER-ASIA DEVELOPMENT BANK

A Thrift Bank

PERSONAL DATA
Name: Nickname:

I.D Number: Type Of I.D.

Date of Birth: Sex: Male Female
Place of Birth:
Present Address:
Permanent Address: (Disregard if Same with Home Address)
Home Ownership: Owned Rented Housing Plan Shared/Others
Length of Stay in Present Address: Length of Stay in Permanent Address:
Civil Status: No. of Dependents:
Name of Spouse: (If Married)
Relationship with the borrower: Contact Number:
EMPLOYMENT STATUS AND ECONOMIC ACTIVITY
If Employed If Self-Employed
Name Of Employer: Business Name:

Name Of Company: Business Address:

Company Address: Nature of Business:
Telephone Number: Telephone Number
Nature Of Business: Name of Business Partner: (If Any):
Position In The Company: Share in the Business:
No. Of Years With The Company: No. of years in the Business:
Regular Monthly Salary: Regular Monthly Sales:
Other Sources of Income (If any):
REAL ESTATE OWNERSHIP
Description Registered In The Name Of: Assessed Value

I agree to become a co-maker of the Center ___________________________ Group #______ by signing the
Promissory Note which will evidence the loan applied for, I granted. I am aware of the responsibility which I will
assume in signing such note.

Further, I hereby acknowledge and authorize; 1) the regular submission and disclosure of my basic credit data (as
defined under Republic Act No. 9510 and its Implementing Rules and Regulation) to the Credit Information Corporation
(CIC) as well as any updates or corrections thereof; and 2) the sharing of my basic credit data with other lenders
authorized by the CIC, and credit reporting agencies duly accredited by the CIC.

I authorized Inter Asia Development Bank to obtain any other information as pertaining with the statement made
herein and as may require. I hereby affirm that all information given above is true and correct to the best of my
knowledge.
_________________________ __________________
Signature of Co-maker Date

CO-MAKER’S PROFILE