(RELOAN) SALARY LOAN/ADVANCE – APPLICATION FORM

Type of Application:  Salary Loan  Salary Advance

PERSONAL INFORMATION
Last Name First Name Middle Name Suffix (e.g. I, II, III, Jr., Sr.)

Civil Status Age No. of Dependent/s

PRESENT ADDRESS
House/Unit/Block/Lot/Floor/Phase No. Building Name/Street Name Brgy./Subdivision/Village Municipality/City

Province Country Postal Code Length of Stay

Type of Ownership RentedOwnedLiving with ParentsOthers

PERMANENT ADDRESS
 Same as to Present Address (Note: If checked, no need to fill up the Permanent Address fields)
House/Unit/Block/Lot/Floor/Phase No. Building Name/Street Name Brgy./Subdivision/Village Municipality/City

Province Country Postal Code Length of Stay

Type of Ownership RentedOwnedLiving with ParentsOthers

CONTACT INFORMATION
Mobile No. Residence No. Office No. E-mail Address

EMPLOYMENT
Employer Employer Address Rank/Designation Length of Service

DepEd Region DepEd Division DepEd Station Email Address

V 013
FINANCIAL DETAILS
Source Gross Amount Net Amount Frequency
Borrower’s Salary Php Php
Salary Monthly
Spouse Income

Other Source of Income

TOTAL INCOMEPhp Php

Credit Card and Credit Limit Other Loans

Source of Funds SalaryBusinessPensionOthers (pls. specify):

Existing BDO Network Bank Account Current AccountSavings AccountOthers (pls. specify)

Existing BDO Account Current AccountSavings AccountOthers (pls. specify)

Other Bank Account Current AccountSavings AccountOthers (pls. specify) Name of Bank/s:
LBP
INFORMATION OF SPOUSE
Last Name First Name Middle Name Suffix (e.g. I, II, III, Jr., Sr.)

Mobile No. Employer Employer Address Employer Tel. No.

LOAN DETAILS
Loan Amount Term of Loan Loan Purpose:
Transactions covered under Salary Based General Purpose CONSUMPTION Transactions covered under Salary Based General Purpose AGRI/AGRA
LOANS: LOANS:
Education  Emergency/Calamities  Household Items
 Hospitalization  Travel  Other Personal Consumption  AGRI/AGRA Purposes

DISBURSAL MODE
BDO Network Bank CASA BDO CASA Payroll Account Others

CHARACTER REFERENCES
Name Contact No. Relationship

Name Contact No. Relationship

I authorize BDO Network Bank, Inc. to obtain any information that may be required in connection with this application. I hereby declare under penalty of perjury that all statements
made here are true and correct.

______________ ______________
Applicant’s Signature Date
 STATEMENT OF NO OBLIGATION
I hereby declare that I have no pending loan deduction/s from Government Service Insurance System (GSIS), Pag-ibig and from any private lending institutions that
is/are to be deducted from my Net Take Home Pay reflected in my latest pay slip/s submitted to BDO Network Bank. This declaration shall remain true from the submission of my
application until the approval or disapproval thereof.

In case of failure of loan deduction from my payroll for whatever reason, I agree to personally pay my monthly amortization due to BDO Network Bank.
DECLARATION AND UNDERTAKING OF COMPLIANCE
This is to further declare that I have no pending application for an indefinite leave of absence or transfer to another station, and no plans to go abroad, resign and to
retire within the payment period of my loan.

This is to further assent that any falsification or subsequent violation on this undertaking can give rise to administrative, civil and criminal liabilities.

__________________________________________________
Signature over Printed Name of Borrower

UNDERTAKING
By signing below, I hereby certify that all information and documents given in this application form are true and correct. I understand that non-disclosure and/or
falsification of information and documents herein required shall be grounds for the disapproval of my application, declaration of my Salary Loan in default, and/or legal action against
me.
I recognize that BDO Network Bank, Inc. (BDO Network Bank) is committed to ensuring the confidentiality of my information under R.A. No. 1405 (Bank Secrecy Law of
1995), as amended, R.A. No. 8971 (General Banking Law of 2000), as amended, R.A. No. 6426 (The Foreign Currency Deposit Act) subject to applicable law, and will exert
reasonable efforts to protect against unauthorized use or disclosure. However, I understand that information regarding my deposit account with BDO Network Bank may be inquired
to, or disclosed, in relation to the evaluation of my application, as may be required by applicable rules and laws, and/or to ensure a successful debit under an Auto-Debit Payment
Arrangement, as applicable, with my deposit account/s with BDO Network Bank should I decide to avail of the Auto-Debit Payment Facility for my Salary Loan. I further authorize
BDO Network Bank to conduct random verification with the Department of Education (DepEd), Bureau of Internal Revenue (BIR), any other appropriate governmental authorities or
third parties including banks and financial institutions to establish authenticity of information declared and documents submitted (e.g. authenticated copy of appointment letter and
pay slips) in relation to the processing and evaluation of my application.

The accomplished application form and requirement/s submitted become the property of BDO Network Bank. BDO Network Bank is under no obligation to return the
said documents to me regardless of the outcome of the application, and BDO Network Bank is under no obligation to disclose the reason/s for such disapproval. I also understand
that BDO Network Bank has the right to assign a lower loan amount than what I applied for.

If my application is approved, I undertake that the proceeds of the Salary Loan will not be used in any endeavor which is against the Philippine laws.

In the event of default or any breach of the terms and conditions and pursuant to the provisions of Articles 1278 to 1290 of the New Civil Code of the Philippines, I
hereby authorize BDO Network Bank to set off as full or partial payment, and/or withhold, to the extent permitted by law, at BDO Network Bank’s option and without need of prior
notice, all monies, funds, and/or proceeds of securities, investments or receivables which may come into the possession or control of BDO Network Bank and/or its Related
Companies, to apply the same in satisfying any or all of my obligations to BDO Network Bank, whether left with them for safekeeping or otherwise, or coming into any of their hands
in any way, to settle any and all of my obligations to BDO Network Bank. I hereby irrevocably authorize BDO Network Bank and/or its Related Companies to debit such amounts as
may be necessary to implement this provision from any of my accounts with BDO Network Bank and/or its Related Companies, immediately after which due notice shall be sent. I
hereby further authorize BDO Network Bank to hold the release of documents, including without limitation, collateral documents, in the possession or control of BDO Network Bank
and/or Related Companies until any or all of my obligations to BDO Network Bank is satisfied. In addition, all such properties, receivables or securities in the possession or control
of BDO Network Bank and/or its Related Companies are hereby ceded, transferred and conveyed by way of assignment unto BDO Network Bank in order that the same may be
used to satisfy any and all of my obligations to BDO Network Bank in accordance with this provision. For such purpose, and to effectively carry out the powers herein granted, I
hereby unconditionally or irrevocably name and constitute BDO Network Bank and/or its Related Companies to be his/her true and lawful attorney-in-fact, with full power of
substitution, to do or cause to be done any and all acts that are necessary to carry out the purposes of this paragraph, including the power to sell in accordance with law, based on
zonal value, fair market value, or appraised value for real properties and fair market value for personal properties, without the need for any further notice, demand or deed, and to
apply the proceeds of the sale to the satisfaction of my obligations to BDO Network Bank. The appointment of BDO Network Bank and/or its Related Companies is coupled with
interest and is, therefore, irrevocable until any and all of my obligations to BDO Network Bank are fully settled. For the foregoing purposes, I hereby waive my rights in favor of BDO
Network Bank and/or its Related Companies under Republic Act 1405 (The Bank Secrecy Act of 1955), as amended. Section 55 of Republic Act 8791 (The General Banking Law of
2000), as amended, Republic Act 6426 (Foreign Currency Deposit Act of the Philippines), as amended, Republic Act 10173 (Data Privacy Act of 2012) and other laws/regulations,
including all subsequent amendments or supplements thereto, relative to the confidentiality or secrecy of bank deposits/accounts, placements, investments and similar or related
assets in the custody of BDO Network Bank and/or its Related Companies. I shall hold BDO Network Bank and/or its Related Companies, their directors, officers, employees,
representatives and agents free and harmless from any liability arising from BDO Network Bank, and/or its Related Companies’ exercise of their remedies and authorities hereunder
or from any action taken by BDO Network Bank and/or its Related Companies on the basis of and within the framework of the foregoing appointment.

I hereby authorize the transfer, disclosure and communication of any information relating to my accounts with BDO Network Bank to any of the offices, branches,
subsidiaries, affiliates, agents and representatives of BDO Network Bank and third parties by any of them for data processing/storage, customer satisfaction surveys, product and
service offers made to me through mail/e-mail/fax/SMS or telephone and for any other purpose as BDO Network Bank may deem appropriate, and as may be required by law or
regulation. I hereby authorize the regular submission and disclosure to any and all credit information service providers such as, but not limited to the, Credit Information Corporation,
of any information whether positive or negative relating to my basic credit data (as defined under R.A. No. 9510) as well as any updated or correction thereof. The foregoing
constitutes my written consent for any such submission and disclosure of information relating to my account for the purpose indicated above and under applicable laws, rules and
regulations. I agree to hold BDO Network Bank free and harmless from any liabilities that may arise from any transfer, disclosure or storage of information relating to my accounts.

BDO GROUP DATA PRIVACY CONSENT

In compliance with the requirements of the Data Privacy Act, I hereby give my consent to the BDO Group, consisting of BDO Unibank, Inc. and its subsidiaries [the
members of the BDO Group may be accessed at [https://www.bdo.com.ph/privacy-statement], to process, collect, store, my personal information or sensitive personal information
obtained from me in the course of my transaction/s with the BDO Group. I understand and agree that these information may be disclosed or shared by BDO Group to its members
for know-your-client, cross-selling, marketing, or profiling (manual or automatic) purposes to offer and provide new or related products and services of the BDO Group. Further, I
hereby give my consent to any member of the BDO Group to process, collect, use, store, share or disclose my personal information or sensitive personal information to third parties
for legitimate purposes, or to provide services to me or implement transactions which I may request, allow, or authorize.

I confirm that I understand and agree that my information may continue to be processed, collected, used, stored, or disclosed for ten (10) years from my last transaction
date with any member of the BDO Group or until the expiration of the retention limits set by applicable laws, whichever comes later.

I hereby acknowledge and understand that should I wish to withdraw my consent to receive information about new or related products and services of the BDO Group,
or to access, update, or correct certain personal data as set out in this form, I may communicate directly with the relevant member of the BDO Group’s Data Protection Officer
through the email address found at [https://www.bdo.com.ph/privacy-statement]. I further acknowledge and understand that I may access and view the BDO Group’s Data Privacy
Statement at [https://www.bdo.com.ph/privacy-statement] or obtain a copy thereof from the office or branch of the relevant member of the BDO Group.

ENDORSEMENT TO COLLECTION SERVICE PROVIDERS

Should the account be referred to a service provider for collections, the Bank shall notify the Borrower in writing at least seven (7) calendar days prior to the actual endorsement the
name(s) and contact details of the collection service providers to whom the account(s) is/are endorsed. The same period shall be observed in case the account is transferred from
one collection service provider to another.

__________________________________________________ _________________________________
Signature over Printed Name of Borrower Date

BDO Network Bank, Inc. is regulated by the Bangko Sentral ng Pilipinas with contact number (+63 2) 708-7087 and e-mail address [email protected]