Please fill-up this online form completely and send to us to facilitate processing of your loan application secure, fast and easy. You may also download and print our application form online using the link below, fill up the form then fax to our office. All information will be treated strictly confidential. Thank you.

Auto and Cash Loan Application
Type of Applicant:	-Select One- Principal Co-Maker
Loan Applied:	-Select One- Brand New Car Used Car Car as Collateral/Refinancing Salary/Business	Brand:	-Select One- Chery Chevrolet Ford Honda Hyundai Isuzu Kia Mazda Mitsubishi Nissan Suzuki Toyota
Type of Car:		Year Model:
Amount of Car (Pesos):		Down Payment (Pesos):
Amount Financed (Pesos):		Term:	-Select One- 12 18 24 36 48 60
		Next to Continue

Applicant's Information
Applicant's Name (Last, First, Middle) :
Birth Date:	Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007	Age:
Civil Status:	-Select One- Single Married Separated Widow Widower	Gender:	-Select One- Male Female
No. of Dependents:		Education Attainment:	-Select One- College Post Graduate Undergraduate
Citizenship:		ACR Number: (If Foreigner)
Home Address:
Home Status:	-Select One- Owned Not Mortgaged Owned Mortgaged Rented Living with parents / Relatives Free Monthly Rental	Years of stayed:
Home Phone:		Cellphone Number:
Email Address:
Previous Address:
(If less than 2 years at presend address)
Years of Stayed :
Provincial Address:
Owned A Car?	Yes      No	How Many Cars:
Mother's Maiden Name: (Applicable for Salary / Business loan Applicant Only)
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Employment Information
Present Employer:
Career Status:	Employed     Self-Employed	Nature of Business:
Major Products:		Position
Years of stayed		Office Phone:
Business Address:
Years of Business: (If self-employed)		Monthly Salary:
Allowance:		Other Income:
TIN Number:		SSS/GSIS Number:
Previous Employer:		Position:
(If less than 2 years at present Employer)
Years of Stayed:		Office Phone:
Business Address:
Spouse Information
Spouse Name (Last, First, Middle) :
Birth Date:	Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007	Age:
Spouse Employer:		Years of Stayed:
Business Address:		Position:
Office Phone:		Cellphone No.:
Monthly Salary:		Other income:
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Personal and Credit References

Child Name : (Studying) Age: School: Course/year/Grade: Child Name 2: (Studying) Age: School: Course/year/Grade: Nearest Relative: (Not living with you) Relationship: Address: Telephone/Cellphone No:     Personal Reference 1       Name: Address: Telephone/Cellphone No: Personal Reference 2       Name: Address: Telephone/Cellphone No:

Bank Information

Bank Name: Branch: Type of Account: -Select One- Saving Current Payroll Account Number:

Credit Card Information

Credit Card Name: Credit Card No.: Credit Limit: Date Issued: Month January February March April May June July August September October November December Year 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Expiry Date: Month January February March April May June July August September October November December Year 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

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Trade References ( Applicable for Self-Employed Applicant Only )

Major Supplier: Office Address: Contact Person: Telephone/Cellphone No.:

Major Supplier 2: Office Address: Contact Person: Telphone/Cellphone No.:

Major Customer: Office Address: Contact Person: Telphone/Cellphone No.:

Major Customer 2: Office Address: Contact Person: Telphone/Cellphone No.:

Back        Where did you find us : -Select One- 88db.com adpost.com AOLFind Buy and Sell Magazine buyandsellph.com carfinderph.com Google Manila Bulletin Phil. Daily Inquirer Philippine Star sulit.com.ph Through flyers yello.com Other    Type the characterd you see in the picture above.

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For fax form only