66 Motorcentral San Pablo APPLICATION FORM

Located at Colago Ave., San Pablo City Laguna
For more details, visit our shop now or contact us at 0975 915 7271 / 0917 631 2321
CREDIT APPLICATION
FACEBOOK NAME:*
BRAND*
HONDA*
YAMAHA*
KAWASAKI*
SUZUKI*
BAJAJ*
MONARCH*
(B) DOWN PAYMENT*
TERMS OF LOAN*
(All informations will be treated CONFIDENTIAL)
PERSONAL DATA
First Name*
Middle Name
Last Name*
Date of Birth*

MonthDayYear
Date
Age*
Birth Place*
Civil Status*
Citizenship*
Contact Number*
E-mail/Gmail/Facebook Name*
Present Address*
OwnedRentedProvidedAmortized
Length of Stay*
Provincial Address
Length of Stay
Name of Land Lord ( if rental)
Monthly Rental
Contact Number of Land Lord
Do You have a Spouse or Live-in Partner?

YESNO
SPOUSE DATA

(leave blank if Not Applicable)
First Name
Middle Name
Last Name
Age
Date of Birth

MonthDayYear
Date
Birth Place
Contact Number
Citizenship
Occupation
Length of Stay in Work
NAME OF EMPLOYER (leave blank if Not Applicable)
LENGTH OF STAY IN WORK (leave blank if Not Applicable)
ADRESS OF WORK / AGENCY
MONTHLY SALARY (leave blank if Not Applicable)
Tel./Cel No.
NAME OF DEPENDENTS (leave blank if Not Applicable)
RELATIONSHIP TO DEPENDENTS
AGE OF DEPENTS
APPLICANT EMPLOYMENT DETAILS
APPLICANT POSITION*
ASSIGNED WORK*
DATE HIRED:*

MonthDayYear
Date
LENGTH OF STAY IN WORK*
NAME OF EMPLOYER*
ADRESS OF WORK / AGENCY*
MONTHLY SALARY*
TEL NO. / CEL NO OF COMPANY
Do You have other source of income?

YESNO
OTHER SOURCE/S OF INCOME / REMITTANCE
Name of Business
Monthly Income
Remittance
From Whom
Relationship
Character Reference
1*
Relationship*
Phone Number*
Please enter a valid phone number.
Address*
2*
Relationship*
Phone Number*
Please enter a valid phone number.
Address*
3*
Relationship*
Phone Number*
Please enter a valid phone number.
Address*
Signature (Buyer)

Clear
FULL NAME*
LIST OF REQUIREMENTS

2X2 PICTURE

2 VALID IDS W/ 3 SIGNATURE FRONT & BACK

PROOF OF BILLING LATEST ( MERALCO, WATER OR INTERNET BILL)

PROOF OF INCOME ( 1 MONTH LATEST PAYSLIP, REMITTANCE SLIP, BRGY BUSINESS PERMIT)

SKETCH LOCATION OF YOUR HOUSE
2x2 PICTURE*

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2 VALID ID WITH 3 SIGNATURE FRONT*

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2 VALID ID WITH 3 SIGNATURE BACK*

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PROOF OF BILLING ( MERALCO, INTERNET, WATER BILL ) *

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PROOF OF INCOME ( PAYSLIP FOR 1 MONTH, BUSINESS PERMIT, REMMITANCE SLIP FOR 3 MONTHS, WEEKLY PAYOUT FOR 1 MONTH ) *

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SKETCH ( FROM YOUR HOUSE TO THE NEAREST LANDMARK IN YOUR AREA ) *

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How's your experience in filling-out the ONLINE APPLICATION FORM?*
Comment about application form
Please verify that you are human*
Application Result
Should be Empty:

CREDIT APPLICATION

PERSONAL DATA

SPOUSE DATA

APPLICANT EMPLOYMENT DETAILS

OTHER SOURCE/S OF INCOME / REMITTANCE

Character Reference