GMA–7 EMPLOYEES’ MULTI-PURPOSE COOPERATIVE

CIN No. 0105160895; Reg. No. 9520-16003325

GEMPC Building, No. 132 Timog Avenue cor. EDSA, Diliman, Quezon City
Tel. No. 982-7777 local 9960 / 9961

NON-CASH LOAN APPLICATION FORM

DATE:
Control No.:

Please Check Applicable Item/s: Description

APPLIANCES (MODEL)
CELLPHONE / UNIT

GROCERY (1 YEAR)
✔ CANTEEN (1 YEAR)

NAME OF APPLICANT:

HOME ADDRESS:

DEPT. / DIV.:

PROGRAM:

OFFICE / RES. TEL. NO.: CELL NO.:

LOAN COORDINATOR APPLICANT’S SIGNATURE OVER PRINTED NAME

SIGNATURE OVER PRINTED NAME DEPT. / DIV.

GUARANTOR 1

SIGNATURE OVER PRINTED NAME DEPT. / DIV.

GUARANTOR 2

APPROVED BY:

CREDIT COMMITTEE COOP MANAGER

(Any Member From Payroll Section)
 GMA–7 EMPLOYEES’ MULTI-PURPOSE COOPERATIVE
CIN No. 0105160895; Reg. No. 9520-16003325
GEMPC Building, No. 132 Timog Avenue cor. EDSA, Diliman, Quezon City
Tel. No. 982-7777 local 9960 / 9961
PN NO. _______________________

PROMISSORY NOTE
Date Released _________________
Date Due _____________________

KNOW ALL MEN BY THESE PRESENTS:

In consideration for a loan for ______________________________________________________________ PESOS

(P__________________), receipt of which is hereby acknowledged as indebtedness and a lien against my Share Capital and/
or Interest on Share Capital in the GMA-7 Employees’ Multi-Purpose Cooperative, I hereby undertake to pay said Cooperative or
order the herein-mentioned loan with interest at ______% per month plus _____% service fee except appliance loan and in ____
semi-monthly equal installments effective ___________________, ______ and hereby pledge and assign to the said Cooperative
my Share Capital and/or Interest on Share Capital therein as a security for said loan. If the equal installments shall have not been
collected or paid on due date, said unpaid installments shall earn surcharges of 2% interest monthly and a monthly penalty of 2%
until fully paid.

To further secure the payment of said loan, I hereby appoint with the understanding not to revoke this appointment, without
written authority of said Cooperative, the Treasurer of the Cooperative, as my Attorney in Fact in payment of said loan or any
balance thereof, and is authorized to deduct and collect through his/her agent the sum of _______________________________
_________________________________________ Pesos (P_________________) from any of my semi-monthly salary and other
remunerations such as my final pay in case of retirement or resignation to include cash conversion of unused leave credits, 13th
month pay and whatever final pay due me until all said accounts shall have been fully paid.

It is my responsibility as borrower: 1) To monitor the status of the account; 2) To authorize the Cooperative to deduct any
delinquent installments from my Share Capital and/or Interest on Share Capital to satisfy my indebtedness; and 3) To pay directly
to the Cooperative in case the Cooperative failed to effect billing of my account or payment may have been deferred and/or cut off
for whatever circumstance. I further agree that in the event of my separation from employment before full payment of herein loan, I
bind myself to pay in full any outstanding amount of this loan. In case of default and attorney’s services are availed of, an additional
sum equal to twenty five percent (25%) of the total sum due thereon, which shall not be less than Five Hundred Pesos (Ᵽ500.00) for
attorney’s fees aside from expenses of collection and legal costs provided for in the Rules of Court.

As co-makers, we hereby acknowledge, confirm and recognize that this promissory note is being issued in view of the loan
extended by GMA-7 Employees’ Multi-Purpose Cooperative to its active members and regular employees of GMA Network, Inc. or
its subsidiary. If for any reason, we cease to be employees of GMA Network, Inc. or its subsidiary due to retirement or resignation
or separation, then this note will become due and demandable equivalent to the proportionate share of our respective obligations as
co-makers. We further agree that in such event, any amount due as final pay to include cash conversion of unused leave credits,
13th month pay and compensation of whatever nature shall be retained for and directly remitted to GMA-7 Employees’ Multi-
Purpose Cooperative to the extent of our proportionate share of obligation.

Witness our hands this _____ day of___________________, 20____ at Quezon City.

Purpose:______________________________________
_______________________________________ ___________________________________
Signature over printed name
MEMBER/MAKER

___________________________________ ___________________________________
Co-Maker’s Name in Print & Signature Co-Maker’s Name in Print & Signature

__________________________________ ___________________________________
Co-Maker’s Name in Print & Signature Co-Maker’s Name in Print & Signature

Credit Committee:

Edmund J. Garcia Florabel M. Yraola Rosalie G. De Castro

 GMA–7 EMPLOYEES’ MULTI-PURPOSE COOPERATIVE
CIN No. 0105160895; Reg. No. 9520-16003325
GEMPC Building, No. 132 Timog Avenue cor. EDSA, Diliman, Quezon City
Tel. No. 982-7777 local 9960 / 9961

AUTHORITY TO DEDUCT

In connection with the Application for Loan of _________________________________________________________

________________, with GMA-7 Employees’ Multi-Purpose Cooperative (GEMPC) and in conformity with Promissory
Note dated ______________________whereby he/she and we jointly and severally promise to pay GEMPC the
outstanding/overdue obligations of the principal borrower if he/she cannot pay the sum of loan or any balance thereof,
including service fee, interest and penalty from his/her salary and monetary benefits to include cash conversion of
unused leave credits, 13th month pay and final pay in case of retirement or resignation or termination. Until fully paid,
we as co-makers hereby authorize the following:

1. The assignment, in favor of GEMPC the sum of loan or any balance thereof, including service fee, interest
and penalty from our salaries and other remunerations such as our final pay in case of retirement or resignation or
termination to include cash conversion of unused leave credits, 13th month pay and whatever final pay due us.

2. The appointment of GMA Network Inc. or its subsidiary where we are employed as our agent(s) to deduct
said amount from our salaries and other remunerations as enumerated above and whatever final pay due us.

3. The remittance of the sum directly to GEMPC without need of demand.

This authority and assignment is absolute and irrevocable until the total obligation is fully paid.

1)_________________________________ 2)__________________________________
Co-Maker’s Name in Print & Signature Co-Maker’s Name in Print & Signature

_________________________________ _________________________________
Name of Subsidiary, if applicable Name of Subsidiary, if applicable

3)_________________________________ 4)__________________________________
Co-Maker’s Name in Print & Signature Co-Maker’s Name in Print & Signature

_________________________________ _________________________________
Name of Subsidiary, if applicable Name of Subsidiary, if applicable
 GMA–7 EMPLOYEES’ MULTI-PURPOSE COOPERATIVE
CIN No. 0105160895; Reg. No. 9520-16003325
GEMPC Building, No. 132 Timog Avenue cor. EDSA, Diliman, Quezon City
Tel. No. 982-7777 local 9960 / 9961

AUTHORITY TO DEDUCT

For value received in my approved Application for Loan attached hereto, I promise to pay to GMA-7 Employees’ Multi-
Purpose Cooperative or order the sum of pesos _________________________________________________ plus
service fee and interest, and penalty, if applicable.

I agree that the entire balance of this note shall become immediately due and payable without need of
demand in case of my retirement or resignation or termination from GMA Network, Inc. and its Subsidiaries.

I assign in favor of the Cooperative, the above sum of loan or any balance thereof, including service fee, interest
and penalty from my salary, cash conversion of unused leave credits, 13th month pay and whatever final pay due me
in case of retirement or resignation or termination. I hereby authorize GMA Network, Inc. to deduct the full amount and
remit the same directly to the Cooperative.

Press this button before you SIGN to check for any empty field.

________________________ ________________________________________
Date Borrower’s Name in Print and Signature