Loan Agents Information Sheet - New BLANK

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Annex 305-A

Loan Agent Information Sheet

Name: Date of Birth:


Spouse's Name Date of Birth:
Residence Address: Contact Nos.
Employer/ Occupation*:
Employer's Address
(for agencies)
Business Name
Contact Nos.
Business Address:
Individual
Authorized Officers: Sole Prop.
Partnership/ Corp.

Number of years as agent/ agency:


Full-time Part-time Freelance Licensed License #:
Other banks presently
accredited with
Dealers presently dealing
with
Developer/ Developer's
projects presently
accredited
Agencies/ Associations/
Affiliations

Bank Accounts Bank Name 1 Type Bank Name 2 Type

Personal/ Trade Reference 1 Relationship Reference 2 Relationship


References
* If you are a Retiree, please indicate details of your previous employment / business on the spaces provided

Have you ever been involved in a court case? Yes No


If yes, please indicate details/status:
Accreditation Requirements:

Individual: Company:
Completely-filled out Information Sheet Business Permit / DTI Registration
Valid Company ID w/ Photo and Signature Articles of Incorporation / By-laws
1 x 1 ID Photo of Spouse Latest ITR with Audited Financial Statements
Company Profile

I hereby certify that the above statements are true and correct to the best of my knowledge. This information
sheet (or a photocopy) shall authorize RCBC Savings Bank to obtain any information regarding my bank accounts,
loan and credit obligations and court records (if any) and any other information as needed/required.

Loan Agent Signature/Date Spouse Signature/Date

Residence Cert. No. Issued on Residence Cert. No.


Issued on
at at
TIN: TIN:

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