MITSUBISHI PACO OTIS Application Form
I hereby authorize my Agent, Jai Casilang to process and share my personal data to any of its accredited banks, which is likewise authorized to receive, use, collect and process my personal data for the purpose of financing my purchase of auto vehicle/s from the dealer or assignment of dealer's right to its accredited banks, including verification, customer profiling, cross checking and credit investigation. In this regard, my personal information may also be shared with accredited bank's branches, subsidiaries, affiliates, representatives, or third-party service provider. I am also aware that the details of how mg personal data will be processed and the rights available to me are listed in the accredited bank(s) concerned. Thanks for giving us your contact. Pls. expect a call from our sales executive for updates.
Name
*
First Name
Middle Name
Last Name
Address
*
House # Street
Barangay / CITY
Length of Stay
Province
Country
House ownership
*
Please Select
Rented
Owned
Living W/ Family
Mortgaged
BIRTHDAY
*
-
Month
-
Day
Year
Date
CELLPHONE NUMBER
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Civil Status
*
Please Select
Single
Married
Separated
Widow
TIN
Company / Business name
Designation
Yrs. of service
Company / Business Address
Gross Monthly Income / Salary
Bank Reference (depositor)
Government Valid ID's
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Latest Proof of Billing
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Latest COE / DTI or business registration/ Latest Contract (ofw)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
ITR / Latest 3 months bank statement
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: