'BPI Family'_

/f()qSiI1f/LOan APPLICATION FORM v.2016

MY lOAN REQUEST MY LOAN PURPOSE PROPERTY USE

Amount
No. of
Rate Fixing Period
o Construction o Purchase different from collateral o Occupancy
Years o Purchase of House & lot o Home Improvement / Renovation DOwner
01 Year 06-10 Vrs o Purchase of Condominium o Business loan o Others:
02-3 Years 011-15 Vrs o Purchase of Townhouse o Refinancing
04-5 Years 016-20 Vrs o Purchase of Lot o Personal Consumption / Multi-purpose o Investment
for:
ABOUT THE COLLATERAL I AM OFFERING
Address of Collateral being offered TCT/CCT No.
Registered in the name of
Contact Person (to schedule appraisal)
Mobile No. Telephone No.

MY PERSONAL INFORMATION
Name Date of Birth Age
As indicated in Birth Certificate Last First Middle MM DO YYYY
Marital 0 Unmarried o legally Separated / Annulled o Widowed Gender 0 Male 0 Female
Status 0 Married D Divorced if yes, country: _ 555 No. or GSIS No. _

Nationality Citizenship Birth Place Tax Identification No. (TIN) _

Mother's Maiden Name

Complete Present Address Resident Since

Complete Permanent Address No. of Children and Ages

No. of Dependents
Complete Previous Address
Home Ownership 0 Owned o Rented (Amount P /month) Mailing Address 0 Present
o Used Free o Mortgaged (Indicate in My/Our Existing loans below) o Permanent
Residence Phone Mobile Phone Email
MY SPOUSE'S INFORMATION
Name Date of Birth Age __
As indicated in Birth Certificate last First Middle MM DO YYYY
Nationality Citizenship Birth Place 555 No. or GSIS No.
Mother's Maiden Name Tax Identification No. (TIN)

Residence Phone Mobile Phone Email

MY/OUR FINANCIAL INFORMATION
BORROWER SPOUSE

Employment Type 0 Employed DOFW Employment Type 0 Employed DOFW

o Self-Employed o Others: o Self-Employed o Others:
o Professional o Professional
Employer / Business Name Employer / Business Name
Office Address Office Address
Telephone No. Telephone No.
Nature of Business Nature of Business
Present Title / Position Present Title / Position
Date Hired / Start of Business Date Hired / Start of Business
MM DD yyyy MM DD yyyy

Previous Employer Previous Employer

Previous Title / Position Previous Title / Position
Years of Employment / Business _ Years of Employment / Business _
Gross Annual Salary P Gross Annual Salary P
Allowances P Allowances P
Business Income P Business Income P
Commissions P Commissions P
Rental Income P Rental Income P
Others: P Others: P
TOTAL P TOTAL P
MY/OUR EXISTING LOANS
Name of Creditor / Bank Type of loan Maturity Date Original loan Amount Outstanding Balance Monthly Amortization

MY/OUR DEPOSIT ACCOUNTS

Bank and Branch Address Account Type (Check all that apply) Account Number/s
o Savings o Time Deposit o Others:
o Checking o Investment
o Savings o Time Deposit o Others:
DCheckin g o Investment
MY/OUR TRADE REFERENCES (IF WITH BUSINESS)
Name of Supplier/Customer Address Telephone Number Contact Person

.
NOTE: Please fill.out a separate application form for proposed co-borrower / co-mortgagor
 RELATIONSHIP TO BFSB, BPI. ANO BPI SUBSIDIARIES AND AFFILIATES. ETC. (in line with BSP Cir. 749)
Are you a Director, Officer, or Stockholder (DOS) of DYes If Ves, specify your company and Company (e.g. BPI) Affiliation/Position (e.g.
BPI Family Savings Bank (BFSB), BPI. or any BPI DNa position or affiliation. Director)
subsidiary and/or affiliate?
Are you related to a DOS of BFSB. BPI, or any BPI DYes If Yes, specify the name/s and Name - Relationship to DOS - Company & Position
subsidiary and/or affiliate (e.g. BPI Leasing, BPI DNa relationship. such as, but not limited to: (e.g. Juan Dela Cruz - First Cousin - BPI, AVP)
Capital, BPI/MS, etc) or the Ayala Group of Spouse, Relative by consanguinity or
Companies (e.g. Ayala Corp. Ayala land Inc, etc)? affiliation (e.g. parent, child, brother,
sister-in-law, grandparent. niece. uncle,
Note: Please disclose all relationships. A separate first cousin, etc) or Others (e.g. general
sheet may be attached if necessary partner, co-owner of collateral, etc).
TERMS AND CONDITIONS (PLEASE READ BEFORE SIGNING)
I (We) confirm that:
• All the statements, information and supporting documents provided by me (us) are true, correct and accurate;
• Where the information or data provided was collected by me (us) from third party sources, the relevant consent has been secured by me (us) from the relevant
parties to whom such information relates.
• Any material misrepresentations or falsity or omission herein will be construed as an act to defraud the Bank and may be a ground for the denial of my (our)
application or, if already granted, the cancellation or termination thereof, without prejudice to such civil and/or criminal liability that the Bank may pursue
against me (us).
• It is the sole prerogative of the Bank to grant or deny my (our) application and should the same be denied, the Bank has no obligation to provide me (us) the
reason for such decision, except as otherwise provided by law.
All information and documents obtained by the Bank in connection with my (our) application shall remain the property of the Bank.
• The Bank may impose such terms, conditions and requirements as it may deem necessary or proper relative to my (our) availment of any of the Bank's products.
services, facilities and channels.
I (we) shall notify the Bank of any material change affecting the information and documents provided by me (us).
• I (we) may receive updates, notices and announcements on my (our) application and/or any of the Bank's products, services facilities and channels via SMS/text,
email or fax transmission or such other means of communication deemed appropriate by the Bank.
Where applicable, the Bank may enroll my (our) approved application with any credit protection provider, or guarantee program of any institution, whether
public or private, at the Bank's sale option.
I (we) have read and understood BPI's Terms and Conditions governing Products, Services, Facilities and Channels found at bpiexpressonline and expressly
agree, where applicable, to the term and conditions thereof.
• The foregoing shall apply to all products, services, facilities and channels of the Bank that I (we) may avail of.

1 (We) consent that-

You will keep information relating or pertaining to me (us) including, but not limited to, any information on my (our) accounts, transactions, deposit accounts, credit
relationships, and/or credit fodlities (the "Information") confidential except that for purposes of the transaction herein contemplated and in connection with BPI
Family Savings Bank's (BFSB) (i) impfementation, administration, facilitation and enhancements of its products, services, facilities and channels, (ii) pursuit of its
marketing, promotional, communication, commercial and research objectives, (iii) regular conduct of business, and/or (iii) compliance with the requirements of
applicabfe lows and/or government regulators or supervisory bodies, I (we) consent to BFSB's, its directors, officers, employees, advisers, auditors, agents and
representati'les (coffectively, the "Bonk"):
0) collection, use, storage, consofidotion and processing (coffectively, "process" or "processing") of Information;
b) outsourcing of the processing of Information to service providers, whether within or outside the Philippines;
c) verification or validation of Information from any and all sources and in any reasonable manner, including but not limited to:
(i) the Bureau of Internaf Re'lenue (BIR) to establish the authenticity of my (our) income tax return ("ITR") and the accompanying financial statements which I
(we) submitted to the Bonk; and
(ii) courts or government or administrative agencies or arbitral tribunals on the status of any case or proceeding to which I am (we are) a party.
d) disclosure and shoring of Information to:
i. BFSB'sparent, subsidiaries, affiliates and related interests (the "BPI Group of Companies");
ii. credit information or investigation companies, credit bureaus (including, but not limited to, the Credit Information Corporation (Cfe) pursuant to Republic
Act No. 9510 and its implementing rufes and regulations), financial institutions, consumer reporting or reference agencies, credit protection provider or
guarantee institutions, brokers, insurers, underwriters;
iii. any judicial, governmentaf, supervisory, regulatory or equivalent body of the Philippines or other jurisdictions; such person or entity as required by the lows
or regulations of any country with jurisdiction over the affairs or business of the Bonk or any member of the BPI Group of Companies; stock exchange on
which the shores or other securities of the Bonk or any member of the BPI Group of Companies are fisted pursuant to its rules;
iv. any potential transferee or assignee of the Bank's rights and/or obligations under the relevant contracts or agreements;
v. service providers engaged by the Bonk or by any member of the BPI Group of Companies, marketing, promotional, network, loyalty program and joint
venture partners and other relevant external parties, whether based within or outside the Philippines ( collectively, the "Relevant Parties" ); and,
vi. such other persons or entities that {the Bank! or any member of the BPf Group of Companies, may deem necessary or appropriate to facilitate the above-
stated purposes or those thot may relate to or arise therefrom, as and when required by the circumstances.

Theforegoing constitutes my (our) express consent under the applicable confidentiality and data privacy lows of the Philippines and other jurisdiction and agree to
hold the Bonk, each member of the BPf Group of Companies and the Relevant Parties, free and harmfess from any and all liabilities, claims, damages and suits of
whatever kind and nature, that may arise in connection with the impfementation and compliance with the authorization conferred by me (us) hereunder.

Product Bundle - FREE BPI Express Credit card.

Terms and Conditions governing the issuance and use of the Card will apply.
Approval and issuance of the BPI Express Credit Card shall be subject further to the sole discretion of BPI and its applicable credit guidelines .
• Annual membership fee is free for the 1R year.

BY SIGNING BElOW, I/WE AGREE TO THE FOLLOWING:

(i) Apply for the issuance of a BPI Express Credit Card to the Principal Borrower and submit documents required by BPI in connection with my/our
application herein
(iii Fully comply with and abide by all the foregoing Terms and Conditions and the Consent to Disclosure Clause above-cited.
(iii) Confirm that the Referrer indicated below referred and assisted me/us in my/our housing loan application and that she/he is the official referrer of
this transaction

Referred By: Referrer's Name and ID/Code Referrer's Contact No.

o Branch o Developer DOnline
o Sales Officer o Broker o Walk.ln

o No, I am not availing

• ..
: ...
Signature

a BPI Express Credit Card

of Borrower/Mortgagor
over Printed Name
Date Signed Signature
Printed
of Spouse over
Name
Date Signed

Contact Numberjs