ANNAPOLIS FINANCE INC.

CREDIT INVESTIGATION FORM Form no. 004-9112019RM

BORROWER'S PERSONAL INFORMATION SPOUSE' PERSONAL INFORMATION
LAST NAME FIRST NAME MIDDLE NAME LAST NAME FIRST NAME MIDDLE NAME

Birthday Age Sex Civil Status Birthday Age Sex Civil Status
Male Single Married Male Single Married
Female Separated Widowed Female Separated Widowed
SOURCE OF INCOME (you may check all applicable) :
Salary Business Remittance Pension Other: _______

COMPUTATION OF NET INCOME

INCOME EXPENSES
SOURCE AMOUNT
Salary 1 Household:
Salary 2 Rent/Amortization
Borrower
Food Allowance
TOTAL Groceries
Education 1
Salary 1 Education 2
Salary 2 Education 3
Spouse
Education 4
TOTAL TOTAL

Buss. 1 Utilities:
Buss. 2 Electricity
Business
Water
TOTAL Telephone
Postpaid line
Remittance Internet
Pension Cable
Other
Others TOTAL

TOTAL Other Expenses:

TOTAL

Total Income Total Expenses

To be filled up by AFI employee: Checked by:
COMPUTATION OF DISPOSABLE INCOME
MASTER LIST
Total Income
less Borrower: ____________________________
Total Expenses CRECOM Staff (Signature)
Spouse:
Total Disposable Income:

To be filled up by AFI employee:

REMARKS: