APPLICATION FOR LOAN

Name of Spouse/Common-law-Partner

First NameMiddle NameLast Name
Spouse/Partner's Employer
Number of Children
Number of Dependent
Children/Dependent in School(Number)

In Elementary (Ilan ang nag-aaral pa sa elementarya)

In Highschool (Ilan ang nag-aaral pa sa secondarya)

In College (Ilan ang nag-aaral pa sa kolohiyo)State / Province

Postal / Zip Code

BUSINESS/EMPLOYMENT

TYPE N/A IF NOT APPLICABLE/NONE
Name of Business/Employer
Business/Employer Address
Present Position
Supervisor's Name:
No. of years in operation/employment:
Working Hours
If Self-employed, type of Business
Is Duty Station Transfer expected this year/next year? YES NO .If Yes, Where? Ending date: Date
References : ( Mga Sanggunian-Halimbawa. si kapitan juan dela cruz)
1. NAME ADDRESS CONTACT NUMBER
2.NAME ADDRESS CONTACT NUMBER

INCOME/ASSETS
(Kita o mga Ari-arian)
(Type N/A if not Applicable/None)

Business Income Php   Amount   per
Employment Income Php   Amount   per
Other Income Php   Amount   per
Spouse/Partner Income Php   Amount   per
Share Capital Php   Amount   Depository   Bank/Coop
Amount in Savings Php   Amount    Depository   Bank/Coop
Amount in Checking Php   Amount    Depository   Bank/Coop
Average Monthly expenses Php   Amount
NET INCOME Php   Amount

List of Assets Owned and Location( listahan ng mga pag-aari. ex. house & lot)
1. List of Assets & Location Pledge as Collateral?(Yes/No) YES/NO
2. List of Assets & Location Pledge as Collateral?(Yes/No) YES/NO
3. List of Assets & Location Pledge as Collateral?(Yes/No) YES/NO
DEBTS (Mga Pinagkakautangan pang iba)
Creditor's Name Original Amount Present Balance
1. Creditor's Name , Origianl Amount , Present Balance
2. Creditor's Name , Origianl Amount , Present Balance
3. Creditor's Name , Origianl Amount , Present Balance

I warrant to the truth and veracity of all the data, information furnished herein to the best of my knowledge. Any misdeclaration that will be discovered during credit investigation will automatically cause the disapproval of this application. I expressly submit to any credit investigation as well as to furnish any other requirements of the cooperative by reason hereof.

I hereby acknowledge and authorize: 1) the regular submission and disclosure of my basic credit data (as defined under Republic Act No. 9510 and its implementing Rules and Regulations) to the Credit Information Corporation as well as updates or corrections thereof; and 2) the sharing of my credit data with other lenders authorized by CIC, and reporting agencies duly authorized by CIC.

(Ginagarantiyahan ko sa katotohanan at katotohanan ng lahat ng data, impormasyong ibinigay dito sa abot ng aking pagkakaalam. Ang anumang maling pahayag na matutuklasan sa panahon ng pagsisiyasat sa kredito ay awtomatikong magiging sanhi ng hindi pag-apruba ng application na ito. Malinaw kong isinumite sa anumang pagsisiyasat sa kredito pati na rin upang maibigay ang anumang iba pang mga kinakailangan ng kooperatiba sa pamamagitan nito.

Sa pamamagitan nito kinikilala at pinapahintulutan ko: 1) ang regular na pagsumite at paghahayag ng aking pangunahing data ng kredito (tulad ng tinukoy sa ilalim ng Batas Republika Blg. 9510 at ang pagpapatupad ng Mga Panuntunan at Regulasyon) sa Credit Information Corporation pati na rin ang mga pag-update o pagwawasto nito; at 2) ang pagbabahagi ng aking data sa kredito sa ibang mga nagpapahiram na pinahintulutan ng CIC, at mga ahensya ng pag-uulat na pinahintulutan ng CIC.)

Applicant's Signature

Clear
Member-Upload Electronic Signature(Scanned/Picture)

Browse Files

Cancelof
Member's Name
First Name MI. Surname
Date of Application

MonthDayYear
Date
Spouse/Partner Approval
First Name MI. Surname
Spouse/Partner Approval Signature

Clear
Upload Spouse/Partner E-Signature(Scanned/picture)

Browse Files

Cancelof
Co-Maker 1(Should be a BHIARCO Member)
First Name MI. Surname and Contact Number
Co-Maker 2(Should be a BHIARCO Member)
First Name MI. Surname and Contact Number
Should be Empty:

APPLICATION FOR LOAN

BUSINESS/EMPLOYMENT