Document
Document
Last Name First Name Middle Name Birthdate Sex Civil Status Nationality Mother's Maiden Name No. of Dependents Home Address Zip Code Years of Stay Home Ownership Previous Address Billing Address Provincial Address No. of Vehicles 1
FEMALE SINGLE FILIPINO LOURDES OCON RUBI Ages 5 PRK 5 SAN ROQUE, MACO 8806 17 OWNED
[email protected] 408268099
09474589875/ 09297841460
Employer/Name of Business Position Nature of Business Office Address Zip Code Telephone Number Fax Number Years in Business Other Income Source
8806
4 ALLOTTED
08/25/1941
04687924 FILIPINO
Employer/Name of Business Position Nature of Business Office Address Zip Code Telephone Number Fax Number Years in Business Other Income Source
Employer/Name of Business Position Nature of Business Office Address Zip Code Telephone Number Fax Number Years in Business
PENSION
MONTHLY INCOME
Currenc Borrow Currenc Spous Currenc y er y e y Salaries Business Income Allowances Commissions Rental Income Others 84,000 PHP 10,000 PHP
Co-Borrower/ Administrator
156,000
2,000
APPLICATION DETAILS
EXISTING DEPOSITS
Account Number
Current Balance
Card Number
Expiry
Name of Supplier/Customer
Address/Telephone Nos.
PERSONAL REFERENCES
COLLATERAL DATA
REAL ESTATE LALAINE OPPURA PRK 5 SAN ROQUE, MACO COMPOSTELA VALLEY
Please provide details only if you have been referred by an employee of the Bank.
Not Appraisal Fee is PHP 3,000.00 only. This will cover appraisal and credit investigation e: expenses.
AGREEMENT
I(We) affirm that the statements made in this application form are true and correct and agree to notify BPI Direct* of any material changes affecting the information contained herein. I(We) authorize BPI Direct to obtain and verify such information as may be required covering this application from above references or any other sources. By submitting this form, I(We) certify that any material misrepresentation or falsity therein shall be construed as an act to defraud BPI Direct for which civil and/or criminal liability can be pursued against me(us). In case of disapproval of my(our) application, BPI Direct is under no obligation to provide me(us) with the reason for such decision. I(We) agree that all information obtained by BPI Direct shall remain its property whether or not the loan application is approved. *All approved online applications will be booked with BPI Direct. However, BPI Family Bank, as the Service Agent of BPI Direct, will be handling the processing of your loan. Therefore, all communication regarding your loan application shall be with BPI Family Bank in behalf of BPI Direct. Please wait for the application confirmation page to appear to confirm that your application has been received.