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    Application Form

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    milaflor zalsos
    This document is a loan application for Binhi Microenterprise Development Foundation. It requests personal information such as name, birthdate, address, contact details, employment and financial information. It asks for information on dependents, assets, existing loans, and references. The applicant authorizes the foundation to verify the provided information and waives privacy protections to allow for disclosure of relevant facts.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Application Form

    Uploaded by

    milaflor zalsos
    89 views2 pages
    This document is a loan application for Binhi Microenterprise Development Foundation. It requests personal information such as name, birthdate, address, contact details, employment and financial information. It asks for information on dependents, assets, existing loans, and references. The applicant authorizes the foundation to verify the provided information and waives privacy protections to allow for disclosure of relevant facts.

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    This document is a loan application for Binhi Microenterprise Development Foundation. It requests personal information such as name, birthdate, address, contact details, employment and financial information. It asks for information on dependents, assets, existing loans, and references. The applicant authorizes the foundation to verify the provided information and waives privacy protections to allow for disclosure of relevant facts.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    89 views2 pages

    Application Form

    Uploaded by

    milaflor zalsos
    This document is a loan application for Binhi Microenterprise Development Foundation. It requests personal information such as name, birthdate, address, contact details, employment and financial information. It asks for information on dependents, assets, existing loans, and references. The applicant authorizes the foundation to verify the provided information and waives privacy protections to allow for disclosure of relevant facts.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    BINHI MICROENTERPRISES DEVELOPMENT FOUNDATION, INC.

    Espinueva Bldg., Rizal-Yacapin Sts., Cagayan de Oro City


    GENERAL PURPOSE LOAN APPLICATION

    Principal Forms
    This is to authorize Binhi Microenterprise Dev’t Foundation, Inc. or any of its officer or representative/s to conduct PICTURE 2X2
    the corresponding credit verification about my loans and deposit in your company and furnish them the data they
    needed below. I /We hereby waive the benefit and the protection of the Bank Secrecy Law – 1405, Data Privacy
    Act – R.A. 10173 and I undertake not to hold your Bank/Company and any of your authorized representative liable
    for or on account of the disclosure of facts maintained herein.

    PERSONAL INFORMATION
    LAST NAME FIRST NAME MIDDLE NAME SUFFIX

    BIRTH DATE AGE PLACE OF BIRTH

    CITIZENSHIP CIVIL STATUS SEX LOAN PURPOSE

    EMAIL ADDRESS TELEPHONE NO. CELLPHONE NO. Business Salary

    HOME ADDRESS : Lot no. Blk. No. Street, Subd., Brgy., Town/City/Province

    LENGTH OF STAY RENTED/BOARDING OWN HOUSE/HOME


    LIVING WITH RELATIVES MORTGAGED WITH _____________________________

    PRESENT ADDRESS : Lot no. Blk. No. Street, Subd., Brgy., Town/City/Province
    LENGTH OF STAY

    FATHER’S FULL NAME : CONTACT NO. OCCUPATION

    MOTHER’S FULL NAME : CONTACT NO. OCCUPATION

    PROVINCIAL ADDRESS ( PARENTS/GRANDPARENTS):


    LENGTH OF STAY

    IF EMPLOYED
    Current/Previous Employer: Contact Person: Contact No.:

    Employer Address: Position: Dep’t/Branch Assign:

    Length of Service: Salary: Other Income:

    Salary Payroll Schedule : If ATM payroll - Bank Name: Bank Branch/Location:

    If have Checking / Saving Account: Account No.: Date Opened: Bank Status:

    IF SELF EMPLOYED / BUSINESS


    Name Of Business: Contact Person: Contact No.:

    Nature Of Business: Position: Dep’t/Branch Assign:

    Length of Operation: Gross Income: Other Income:

    Name of Supplier : Contact Person: Supplier: Contact No.:

    If have Checking / Saving Account: Account No.: Date Opened: Bank Status:

    SPOUSE INFORMATION
    LAST NAME FIRST NAME MIDDLE NAME SUFFIX

    BIRTH DATE AGE PLACE OF BIRTH

    CITIZENSHIP CIVIL STATUS SEX OCCUPATION

    EMAIL ADDRESS TELEPHONE NO. CELLPHONE NO. Business Salary

    HOME PRESENT ADDRESS : Lot no. Blk. No. Street, Subd., Brgy., Town/City/Province

    FATHER’S FULL NAME : CONTACT NO. OCCUPATION

    MOTHER’S FULL NAME : CONTACT NO. OCCUPATION

    PROVINCIAL ADDRESS ( PARENTS/GRANDPARENTS):


    LENGTH OF STAY

    Children’s and Other dependent’s living with the family No. of Dependent’s
    NAME Birth Date AGE SCHOOL/EMPLOYER

    1.

    2.

    3.

    4.

    CERTIFICATION _____________________________________________
    This is to certify that I personally examined the herein
    true and correct I am satisfied that he/she voluntarily executed Applicant’s Signature Over Printed Name (with Full Middle Name)
    And fully understood his/her information

    NEXT PAGE AT THE BACK ( Pages 1-1)


    Provide details of all personal major assets, vehicle, cars, real property and etc. Date Acquired
    1.
    2.
    3.

    Existing Liabilities/ Loans : Creditor’s Company Address and Contact no. Due Date Balance
    1.
    2.
    3.

    CO-BORROWER/CO-MAKER’S INFORMATION
    NAME Birth Date AGE ADDRESSED

    1.

    2.

    3.

    PLEASE SKETCH YOUR HOME ADDRESS

    PLEASE SKETCH YOUR WORKED/OFFICE ADDRESS

    ( Pages 2-2)

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