LOAN APPLICATION TDMPC Form No. TD-011 Designed: January 01, 2010 NO.

REGULAR SPECIAL EMERGENCY

DATE

MO. DA. 9 15

I HEREBY APPLY FOR A LOAN ON THE AMOUNT/PERIOD AND PURPOSE SPECIFIED HEREIN. I FURTHER CERTIFY THAT THE STATEMENT AND DATE INDICATED HEREWITH ARE TRUE AND CORRECT, AND SUBMITTED FOR THE PURPOSE OF OBTAINING CREDIT. AMOUNT
NAME: HOME ADDRESS: SIGNATURE:

10,000

NO. OF MOS. PAYABLE

5 months
PURPOSE

MONTHLY AMORTIZATION

2000

Jhun

IgnacIo
MEMBER ID NO.

Financial shortage
7500
MEMBERSHIP DATE MO. 02 DA. 05

Palimbang Calumpit
MONTHLY SALARY

ACTION ON LOAN APPLICATION (FOR TOTALDEV USE ONLY)

DEPOSITS/LOANS
AS OF

DATE

MO.

DA.

DATES

SEMI-MONTHLY DEDUCTION

OTHER INFORMATION

SHARE CAPITAL SAVINGS DEPOSIT

ORIGINAL AMOUNT OF LOAN

P
AS OF

P P
DATE RELEASED

P
REGULAR

P
EMERGENCY

P P P

P
SPECIAL

P
REGULAR

LOAN BALANCE

AS OF AS OF AS OF

P
EMERGENCY

THIS IS TO CERTIFY THAT THE INFORMATION STATED HEREWITH ARE TRUE AND CORRECT.
POSTED BY: DATE:

P
SPECIAL

APPROVED AMOUNT
NO. OF MOS. PAYABLE

DISAPPROVED
REASON SIGNATURE

CREDIT COMMITTEE
CHAIRMAN

P 10,000
AMORTIZATION/MONTH

ADDITIONAL INSTRUCTION

SECRETARY MEMBER

RECOMMEND RELEASE ON

DATE OF CHECK

MO.

DA.

YR RELEASE APPROVED BY:

REMARKS/BOARD ACTION

MANAGER

TD-011 1, 2010 YR. 2011

YR 2010

YR

ORMATION

REWITH ARE

MITTEE

RMAN

TARY

BER

ARD ACTION

LOAN NOTES
I/We, the undersigned, bind myself/ourselves jointly and severally to pay TOTALDEV Multipurpose Cooperative the sum of ____________10,000________________ with interest computed on the unpaid balance at the rate of one percent per month, interests deductible in advance over a period of _____5______ mos. at P ____1000__ per semi-monthly installments, the first payment to be made on ______11-05-2011______ and a like amount every payday thereafter until the full amount has been paid.

In case of any default in payments of semi-monthly installments, the entire balance of the note shall become immediately due and demandable without prior notice to the maker/co-maker, at the option of the holder. Each party to this note whether as maker, co-maker, indorser or guarantor; severally waives presentment of payment for formal demand, protest and notice of protest and dishonor of the same. It is further agreed that in case payment shall not be made at maturity. I/We shall pay the cost of collection and attorneys fees in an amount equal to twenty percent of the principal and interest due on this note, but in no event shall such charge be less than TEN PESOS. In case of judicial execution of this obligation or any part of it the debtor waives all his rights under the provisions of Rule 3, Section 13 and Rule 39, Section 12 of the Rules of Court.

AUTHORITY
In the absence of my/our salary due me/us at the time of my/our separation from service, I/We hereby authorize the Cooperative to deduct out of the Proceeds of our severance Pay any amount due the TotalDev Multipurpose Cooperative and remit same to the Treasurer.

PLEDGE OF DEPOSITS
I/We, the undersigned hereby pledge all deposits and payments on deposits which I/We now have or hereafter may have in this Cooperative as security for the above loan. This pledge is given to secure the payment of the above describe loan and interest, fines, cost or expenses that may accrue thereon, and I/We hereby authorize this Cooperative to apply any or all such deposits and payments on deposits to the payment of said loan and interest, fines, cost or expenses. INSTRUCTIONS: PRINT ENTRIES & SIGNED OVER PRINTED NAME
MAKER / BORROWER COMPANY TEL.NO HOME ADDRESS

C O

M A K E R S