Please fill out all the boxes in this form to ensure fast processing of your application.
Incomplete information will cause delay. Submit this form together with the
Requirements for Loan Application (please refer to the back page) to your HR. For inquiries, please call up 0916-2150828.
COLLATERAL / VEHICLE TO BE PURCHASED
LOAN REQUESTED (FOR BRAND NEW VEHICLES ONLY) HRD CERTIFICATION
Unit Model Name and Year
Amount Primary User Please accomplish in company letterhead. Format
Unit Price to be provided by Ayala Coop.
Downpayment
No. of Years
BORROWER
Last Name, First Name, Middle Name Date of Birth Age TIN
Home Address Tel No. (Home) Home Ownership: Civil Status:
Single
Owned Married ____years
No. of Children and Ages Rented
Living with Parents / Relatives Widowed ____years
Separated ____years
Mobile No. Fax No. Tel No. (Provincial)
if separated: Legal
Provincial Address Tel No.(Office)
Not Legal
Employer Date Hired Personal Email Address Office Email Address
Office Address Position Yrs. in Employment
CO-BORROWER
Last Name, First Name, Middle Name Date of Birth Age TIN
Home Address Tel No. (Home) Home Ownership: Civil Status:
Single
Owned Married ____years
No. of Children and Ages Rented
Living with Parents / Relatives Widowed ____years
Separated ____years
Mobile No. Fax No. Tel No. (Provincial)
if separated: Legal
Provincial Address Tel No.(Office)
Not Legal
Employer Date Hired Personal Email Address Office Email Address
Office Address Position Yrs. in Employment
MONTHLY INCOME
Source Of Income Borrower Co-Borrower Total
Salaries P P P
Allowances
Business Income
Commissions
Rental Income
Others:
TOTAL P P P
DEPOSIT ACCOUNTS
Bank and Branch Address Type of Account Account Number Present Balance
EXISTING LOANS AND FINANCING
Name of Creditor / Bank Collateral Maturity Date Original Amount Outstanding Balance Monthly Amortization