BIRHEN NG BAYANG SAN MATEO MULTI-PURPOSE COOPERATIVE (BBSAMAMUCO)
036 M. H. del Pilar St., Guitnang Bayan 1, San Mateo, Rizal Contact Nos. 8650-5260; 0917-8523176
APPLICATION FOR LOAN
By the Implementing Rules and Regulations of Data Privacy Act of 2012, in disclosing, your personal or sensitive information by answering the form, you consent to the Birhen ng Bayang San Mateo Multi-Purpose Cooperative to access, collect and use your personal information for data gathering with strict confidentiality.
Date Applied:
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name
*
First Name
Last Name
Loan Amount Applied (in words)
*
Ex: Ten Thousand Pesos Only
Loan Amount Applied (in Figures)
*
Ex: 10,000
Type of Loan (Please check 1 only)
*
Short Term Loan: Loan Amount Php4,000-Php20,000 (max. 6 months)
Multi-purpose Loan: Loan Amount Php21,000-Php60,000.00 (max. 12 months)
Productive Loan: Loan Amount Php61,000-Php100,000 (max. 18 months)
Providential Loan (equal to Share Capital; Term: 1 to 12 mos.)
Calamity Loan: Times two of share capital max. loan amount Php20,000
Pension Loan (Loan amount is based on Monthly Pension, 12 months to pay)
Time Deposit Loan (equal to Time Deposit placement)
Emergency Loan (Loan amount is 50% of Share Capital, payable in 2 mos.)
Health Card Loan (Loan Amount Php4,000.00 or Php8,000.00, payable in 5 mos.)
Motorcycle Loan (Loan amount: x3 of Share Capital; Term: Max. 3 yrs.)
ATM Loan (for NSDAPS employees only)
Memorial Loan: Purchased amount plus interest
Memorial Service Loan: St. Peter Service
Restructured Loan (Term: The same with the original loan term)
Loan Term: How many months do you want to pay?
*
Please refer to the TYPE OF LOAN section
Payable Type:
*
Daily
Weekly
Semi-Monthly
Monthly
Loan Purpose (Please check 1 only)
*
Education
Hospitalization
Utilities
Travel
House Renovation
Investments
Retail Store (Sari-Sari Store)
Personal Business
Other Purpose
Payment Option (You may choose more than one)
*
Direct to Office
Deduct from Deposits
For Collection
Gcash
Bank Deposit/Transfer @ BDO Acct. No. 0083 6001 8087
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PERSONAL INFORMATION
You understand that your personal information is protected by R.A. 10173, Data Privacy Act of 2012 and that you are required to provide truthful information.
Year of Membership
you may see on your first transaction inside your passbook.
Your Cooperative Number
You may find it on your passbook.
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
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1979
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1974
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1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
Year
Age:
*
Address:
*
Cellphone Number
*
Please enter registered mobile number.
Format: (0000) 000-0000.
Telephone Number
Please enter a valid phone number.
Format: (0)000-0000.
Email Address:
Please enter a valid Email Address
Facebook Account:
*
Name of your Facebook or link
Co-Maker's Name
*
FULL NAME
Co-Maker's Signature
Spouse Consent's Name
FULL NAME
Signature
Signature of Applicant
*
Type of Government. ID
*
Please Select
Philhealth ID
National ID
TIN
SSS
GSIS
Passport
Driver's License
PRC
Senior Citizen
Postal
Others
ID Number
*
You may find it infront of ID
Take a photo of your Government Valid ID (Landscape)
*
Take a photo of yourself (Portrait)
*
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