Affix Latest

ILOCOS CONSOLIDATED COOPERATIVE BANK

Decent 2"x2"
Branch : ___________________________________________________ ID Picture
Telefax ____________________________________________________

LOAN APPLICATION
Application for: Amount Applied:

Agricultural Loan Commercial Loan Facility Loan Others Industrial

____Crop Production ____Wholesale/Retail _____Purchase of Medical ____Housing /House impr ____Manufacturing
____Livestock/Poultry ____Hotel, Restaurant, Resort Eqmnt ____House Improvement ____Fabrication
____Fisheries ____Transpo & Other Services _____Purchase of Const Eqmnt ____Purchase of Lots ____Construction
____Agrricultural Facility ____Other Logistics _____Purchase of Vehicles/MC ____Salary
____Agricultural Inputs ____Working Capital _____Logistics ____Back to Back
____ Agri-business ____Others (pls. specify) _____ Others (pls specify) ____OFW
____ Others (pls specify)

PERSONAL INFORMATION
Applicant/Borrower Applicant's Spouse
Name:

Present Address:
Permanent Address:

Place of Birth:
Date of Birth:
Marital Status:
Contact No.:
TIN
If with SPA:
Name of Principal
TIN of Principal
email address:
Highest Educational
Attainment:

_____below Elementary _____Elementary ______High School _____College ______Graduate ______Employed

Status of Residence: ____Personally Owned ______Personally owned but mortgaged ______Family Owned ______Rented ______Free

Employment/ Business Name:

Employment /Business
Address:
Nature of Work /Business

Position:
Status :
Condact No.:
email address:

INCOME & EXPENSE

Combined Monthly Income Combined Monthly Expenses
Name of Business/ Applicant Applicant's Spouse
Applicant + Applicant's Spouse
Employer :
Source of Income Description of expenses
Employment : Php Php Household/Living : Php
Business : Education/Tuition Fees :
Allowances : Rentals :
Commissions/Bonuses : Loan amortizations :
Remittances : Transportations/fuels :
Farming : Business Expenses :
Pensions : Others..(specify) :
Others…(specify) : :
Total Monthly Income : Php Php Total Monthly Expense : Php

Total Income ( Applicant & Applicant's Spouse) : Php Net Income : Php
EXISTING BANK INFORMATION-Investment
Transactions Type of Transaction (Savings/Time Deposit/Stocks, etc..) Status Current Balance
Deposit s
Investments

EXISTING BANK INFORMATION-BorrowIngs

Name of Lending Inst./Bank Loan Amount Date granted Date Due Security Status Balance Date
 COMMUNITY PRO FILE & INVOLVE MENT
Name of Organization Address Position

REFERRAL/ENDO RSEMENT
Last Name First Name Middle Name Contact Number

ASSETS & LIABILITIES

Assets Liabilities
Cash on Hand and in Banks Php Accounts Payables Php
Account Receivables Loans Payable
Real Estate Properties Owned Others…please specify
Cars/Trucks Owned (net of Depreciation) ____________________
Household Appliances Owned ____________________
Investments ________________________ TOTAL LIABILITIES

TOTAL ASSETS NETWORTH

LI S T S O F P R O P E R T I E S O W N E D / A C Q U I R E D
Description /Item Location/Make/Model Market Value Year Acquired Mortgaged to: Monthly Amortization

UNDERTAKING
I/we affirm that all information/s furnished herein is/are true and correct and that any misrepresentations or falsity therein will be construed as an act to defraud
ILOCOS CONSOLIDATED COOPERATIVE BANK for which can be a reason for the disapproval of my loan application.
I/we hereby authorize the Bank or its duly authorized representatives 1). To obtain informations about me and from other institutions/individuals on my present
and past dealings and transactions. 2). To conduct appraisal on the property(ies) to be used as collateral and inspect the premises which are part of the subject property
3). and to facilitate the processing of my Loan Applicaction.
I/we agree that this application form and the submitted documents are now property of ICCB and will be used to evaluate whether or not to grant my/our loan.
In case of Loan Disapproval, I/we hereby agree and understand that Ilocos Consolidated Cooperative Bank is not obliged to disclose the reason/s for such
disapproval.
Finally, "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 Regulations) to 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."

SIGNATURE OVER PRINTED NAME OF BORROWER Date SIGNATURE OVER PRINTED NAME OF BORROWER'S SPOUSE

C O - M A K E R S
Name ofCo-maker (1): Name of Co-maker (2)
Name of spouse: Name of spouse
Address: Address:
Birthdate: Birthdate:
Occupation: Occupation:
Position: Position:
Monthly Income: Monthly Income:
Valid ID: Valid ID:
Contact No. Contact No.
Signature over printed name of Co-maker (1) Signature over printed name of Co-maker (2)

*****************************************************************************************************************************
(FOR SALARY LOAN)

TO: ILOCOS CONSOLIDATED COOPERATIVE BANK

___________________ AGREES TO COLLECT THROUGH PAYROLL/PAYSLIP DEDUCTION, THE CORRESPONDING MONTHLY AMORTIZATIONS ON THIS
LOAN AND REMIT SAID AMOUNTS TO ILOCOS CONSOLIDATED COOPERATIVE BANK ON OR BEFORE THE 15TH &/OR 30TH DAY OF EVERY MONTH FOR LOAN
AMORTIZATIONS FOR THE DURATION THAT THE LOAN REMAINS OUTSTANDING.
FINALLY, AT THE REQUEST OF MR./MS. _______________________________ WHO IS EMPLOYED IN THIS OFFICE
___________________________________________ AS ____________________ WITH A MONTHLY SALARY OF __________________
______________________________ (P________________)PESOS ONLY, WE HEREBY AGREE TO DEDUCT THE AMOUNT AS SHOWN IN THE SCHEDULE ATTACHED AND
REMIT THE SAME TO YOU UNTIL HIS/HER LOAN WITH YOUR BANK IN THE AMOUNT OF _______________________________________ (P________________) PESOS
ONLY SHALL HAVE BEEN FULLY PAID.

Very truly yours,

Head of Office/Authorized Reperesentative Party Authorized to Deduct

Signature Over Printed Name Signature Over Printed Name
Date: __________________ Date: __________________
 FOR BANK'S USE ONLY

Bank's Action on Loan Application

Branch Manager's Capacity (100,000.00 & below) GM Capacity (100,001 to 500,000.00) President's Capacity (500,001 to 1million)
Manager's Date General Manager's Date President's Date
Approved for P____________ Approved for P Approved for P
Remarks Remarks Remarks

Manager

General Manager President

Loan Officer

Credit Committee Date Board of Director's Date

Approved for P Approved for P
Remarks Remarks

Signatures Signatures

DOCUMENTRY REQUIREMENTS SUBM ITTE D

Basic Requirements REAL ESTATE MORTGAGE

*Application Form with Promissory Notes (ISCB Form) Original Certificate of Title
*3 copies 2x2ofIdentification
*Photocopy atleast 2 validPicture
Identification Cards Owner’s copy
Certified of TaxofDeclaration
true copy (Lot and
Tax Declaration (Lotbuilding)
and building)
*Community Tax Certificate (Sedula) Current Real Estate Tax Receipt

*Clearances (Barangay/Police/RTC/MTC) Certification of Non Tax Delinquency

*Permits (Barangay/Business) Affidavit of Non Tenancy (if Agricultural land)

*Tax Identification Number Sketch with Vicinity map

*Proof of Mailing Address Special Power of Attorney (if collateral is not owned by borrower)

Specific Requiremenrs (Please check applicable) Mode of Acquisition

*Photocopy of Passport Real Estate Mortgage Contract

*Work Contract Appraisal Report

*Overseas Employment Cert. Fire Insurance (Residential/Commercial lot and houses )

*Collateral (in the absence of the above requirements) Chattel Mortgage

*Bill of Materials 1. Original Copy of Certificate of Registration

*Building Plan w/ Perspective 2. Original copy of Official Receipt

*Cash Flow/Payroll 3. Picture of Motor Vehicle

*Business License/Permit 4. Motor vehicle stencil

*Projected Cash Flow 5. Comprehensive Insurance

*Financial Statement (if more than P500,000.00) 6. Purchase receipt/delivery receipt

*Farm Plan Others:

*Project Proposal _________________________________________________________________________

*Quotation/Delivery Receipt/Feasibility Study _________________________________________________________________________

Approved by: (President Capacity)

President
Loan Amount :___________________
Term : __________________
Date : ___________________
Remarks : ___________________