Telephone Number: PLDT: (632) 5328 – 2191 Mobile Number: 0917-137-2847 Website: www.jkcapital.com.ph Email: [email protected].

ph

APPLICATION FORM / BORROWER

Amount Applied: Terms of Loan: Purpose of Loan: Agent's Code & Name: Date of Application:

PERSONAL INFORMATION
Last Name First Name Middle Name Gender:
Civil Status:
Mother's Maiden Name: Birthdate:
Email Address:
Current Address (Including ZIP code): Nationality:
Length of Stay:
Permanent/Provincial Address (Including ZIP code):

Landline: Mobile Number: SSS Number: TIN:

Home Ownership: Owned Rented: Php.________/Month Mortgaged: Php___________/Month Living with Relatives
Name of Spouse: Nationality:
Address:
Office Email Address:
Name of Employer/Business:
Address: Contact Number:

BUSINESS INFORMATION
Business Name: Nature of Business:
Business Address: Date Registered:
Capitalization:
Business Email Address: Monthly Income:
Branches (if any): Number of employees:
Company SSS/TIN: Contact Number:
Other source/s of income:

HIGHEST EDUCATIONAL ATTAINMENT

School Degree and Major Year

FAMILY INFORMATION
Name School/Employer & Address Birthdate Contact Number

BANK INFORMATION

Bank Name and Branch Account Type Account Number Date Opened Contact Person Contact Number

CLIENT INFORMATION
Name/Business Name Address Contact Number

SUPPLIER INFORMATION

Name/Business Name Address Contact Number

CHARACTER REFERENCE

Name Relationship to Borrower Contact Number

LOANS WITH OTHER FINANCING INSTITUTION

Name and Branch Type of Loan Date Availed Original Amount Outstanding Balance
 Telephone Number: PLDT: (632) 5328 – 2191 Mobile Number: 0917-137-2847 Website: www.jkcapital.com.ph Email: [email protected]

MISCELLANEOUS
Are there past or pending cases against you? Yes No
If yes, please indicate the nature, plaintiff, amount involved and the status.

Do you have past due obligations? Yes No

If yes, please indicate the creditor's name, nature, amount involved and due date.

Was your bank account ever closed because of mishandling or issuance of bouncing checks? Yes No
If yes, please indicate the bank's name, nature amount and date.
Have you ever been diagnosed, treated or given medical advice by a physician or other health care provider? Yes No
If yes, please indicate the condition / diagnosis.

DECLARATION AND SIGNATURE

I/We hereby certify that all information furnished in this form are true and correct, and the signature/s appearing herein are genuine. Should any information furnished herein be found to be
false, JK Capital Finance Inc. may disapprove this application and/or declare the loan due and demandable (in case the loan proceeds have already been released).
JK Capital Finance Inc. and its authorized representative are hereby authorized to validate the information provided in this form, make disclosure/s or share information contained herein or in any
documents / papers submitted in connection herewith to any credit rating investigation company or regulatory body or such other persons it may deem necessary to confirm the veracity of the
information contained therein.
I/We agree that this application form and documents (excluding original bank statements and used checks) submitted in connection herewith become properties of JK Capital Finance Inc. and will
not be returned for whatever reason. I am aware that the statements / information gathered about me will be used to determine my eligibility for this loan. I/We also understand that should my
application be denied, JK Capital Finance Inc. is not obliged to disclose the reason for the disapproval.
ADDITIONAL TERMS AND CONDITIONS
For this purpose, the Borrower waives his/her rights under the provisions of Republic Act No. 1405, otherwise known as the Law on Secrecy of Bank Deposits, and authorizes JK Capital Finance
Inc. to conduct business/trade checking, secure necessary information from any person / entity the Borrower indicated to have had any transaction and/or business dealings with, and conduct
inquiries on the status and details of the Borrower’s loan / borrowing accounts with creditor banks, if applicable. The Borrower further authorizes JK Capital Finance Inc. to conduct an appraisal of
the property that the Borrower is offering as collateral for the loan, if any.
DATA PRIVACY CONSENT
In compliance with the requirements of the Data Privacy Act ("DPA") RA 10173, I/We acknowledge and agree that, in the course of my loan application with JK Capital Finance Inc. and throughout
the term of my loan, if such loan application is accepted for processing, JK Capital Finance Inc. may receive or have access to my personal information which may consider as relevant in evaluating
the loan application; hereinafter collectively referred to as "Private Information." I/we expressly consent the processing, collection, transmission, storage, disposal use and disclosure of Private
Information by JK Capital Finance Inc. I/we will allow members of JK Capital Finance Inc. to process, collect, use, store, or disclose my information to other members, to governmental authorities,
and to third parties, as may be necessary.

BORROWER'S SIGNATURE
Authority to Verify Premises Authority to Verify with Bank

I hereby authorize JK Capital Finance Inc. or any of its representatives to I hereby authorize JK Capital Finance Inc. or any of its representatives to verify
enter and inspect our premises which are part of their credit investigation. our account with Bank: (See attached Authority to Verify with Bank)
(See attached Authority to Verify Premises)

Full Name & Signature of Borrower Full Name & Signature of Borrower

Mandatory Documentation:
1. Please attach 2 different Government ID photocopies:
(each with 3 specimen signatures)
2. Please attach proof of residence: 2x2 Picture
• latest billing statement
• screenshot of residence Google Maps
3. Please attach proof of business:
• latest billing statement
• screenshot of business location Google Maps
4. Please attach copy of DTI/SEC
5. Please attach Mayors Permit
6. Please attach 3 months Bank statements
Telephone Number: PLDT: (632) 5328 – 2191 Mobile Number: 0917-137-2847 Website: www.jkcapital.com.ph Email: [email protected]

APPLICATION FORM / CO-BORROWER

Amount Applied: Terms of Loan: Purpose of Loan: Agent's Code & Name: Date of Application:

PERSONAL INFORMATION
Last Name First Name Middle Name Gender:
Civil Status:
Mother's Maiden Name: Birthdate:
Email Address:
Current Address (Including ZIP code): Nationality:
Length of Stay:
Permanent/Provincial Address (Including ZIP code):

Landline: Mobile Number: SSS Number: TIN:

Home Ownership: Owned Rented: Php.________/Month Mortgaged: Php___________/Month Living with Relatives
Name of Spouse: Nationality:
Address:
Office Email Address:
Name of Employer/Business:
Address: Contact Number:

BUSINESS INFORMATION
Business Name: Nature of Business:
Business Address: Date Registered:
Capitalization:
Business Email Address: Monthly Income:
Branches (if any): Number of employees:
Company SSS/TIN: Contact Number:
Other source/s of income:

HIGHEST EDUCATIONAL ATTAINMENT

School Degree and Major Year

FAMILY INFORMATION
Name School/Employer & Address Birthdate Contact Number

BANK INFORMATION

Bank Name and Branch Account Type Account Number Date Opened Contact Person Contact Number

CLIENT INFORMATION
Name/Business Name Address Contact Number

SUPPLIER INFORMATION

Name/Business Name Address Contact Number

CHARACTER REFERENCE

Name Relationship to Borrower Contact Number

LOANS WITH OTHER FINANCING INSTITUTION

Name and Branch Type of Loan Date Availed Original Amount Outstanding Balance
 Telephone Number: PLDT: (632) 5328 – 2191 Mobile Number: 0917-137-2847 Website: www.jkcapital.com.ph Email: [email protected]

MISCELLANEOUS
Are there past or pending cases against you? Yes No
If yes, please indicate the nature, plaintiff, amount involved and the status.

Do you have past due obligations? Yes No

If yes, please indicate the creditor's name, nature, amount involved and due date.

Was your bank account ever closed because of mishandling or issuance of bouncing checks? Yes No
If yes, please indicate the bank's name, nature amount and date.
Have you ever been diagnosed, treated or given medical advice by a physician or other health care provider? Yes No
If yes, please indicate the condition / diagnosis.

DECLARATION AND SIGNATURE

I/We hereby certify that all information furnished in this form are true and correct, and the signature/s appearing herein are genuine. Should any information furnished herein be found to be
false, JK Capital Finance Inc. may disapprove this application and/or declare the loan due and demandable (in case the loan proceeds have already been released).
JK Capital Finance Inc. and its authorized representative are hereby authorized to validate the information provided in this form, make disclosure/s or share information contained herein or in any
documents / papers submitted in connection herewith to any credit rating investigation company or regulatory body or such other persons it may deem necessary to confirm the veracity of the
information contained therein.
I/We agree that this application form and documents (excluding original bank statements and used checks) submitted in connection herewith become properties of JK Capital Finance Inc. and will
not be returned for whatever reason. I am aware that the statements / information gathered about me will be used to determine my eligibility for this loan. I/We also understand that should my
application be denied, JK Capital Finance Inc. is not obliged to disclose the reason for the disapproval.
ADDITIONAL TERMS AND CONDITIONS
For this purpose, the Borrower waives his/her rights under the provisions of Republic Act No. 1405, otherwise known as the Law on Secrecy of Bank Deposits, and authorizes JK Capital Finance
Inc. to conduct business/trade checking, secure necessary information from any person / entity the Borrower indicated to have had any transaction and/or business dealings with, and conduct
inquiries on the status and details of the Borrower’s loan / borrowing accounts with creditor banks, if applicable. The Borrower further authorizes JK Capital Finance Inc. to conduct an appraisal of
the property that the Borrower is offering as collateral for the loan, if any.
DATA PRIVACY CONSENT
In compliance with the requirements of the Data Privacy Act ("DPA") RA 10173, I/We acknowledge and agree that, in the course of my loan application with JK Capital Finance Inc. and throughout
the term of my loan, if such loan application is accepted for processing, JK Capital Finance Inc. may receive or have access to my personal information which may consider as relevant in evaluating
the loan application; hereinafter collectively referred to as "Private Information." I/we expressly consent the processing, collection, transmission, storage, disposal use and disclosure of Private
Information by JK Capital Finance Inc. I/we will allow members of JK Capital Finance Inc. to process, collect, use, store, or disclose my information to other members, to governmental authorities,
and to third parties, as may be necessary.

CO-BORROWER'S SIGNATURE

Authority to Verify Premises Authority to Verify with Bank

I hereby authorize JK Capital Finance Inc. or any of its representatives to I hereby authorize JK Capital Finance Inc. or any of its representatives to verify
enter and inspect our premises which are part of their credit investigation. our account with Bank: (See attached Authority to Verify with Bank)
(See attached Authority to Verify Premises)

Full Name & Signature of Co-Borrower Full Name & Signature of Co-Borrower

Mandatory Documentation:
1. Please attach 2 different Government ID photocopies:
(each with 3 specimen signatures)
2x2 Picture