Loan Application Form

Agriculture, Fisheries and Rural Development (AFRD) FinancingSmall and Medium Enterprises LoansLoans to Individuals for Consumption PurposesMicrofinance LoansLoans to Individuals for Housing PurposesLoans to Individuals for Other Purposes
INSTRUCTIONS: Fill up the box properly if in doubt of any question or blank, ask the loan clerk or any Bank representative to assist you. This application shall be accomplished accompanied by all the other requirements. Write “N/A” whenever information is NON-APPLICABLE.
I HEREBY APPLY A LOAN OF*
FOR A PERIOD OF*
DAYS FOR THE PURPOSE OF:
Special Purpose*
Date needed*

MonthDayYear
Amount*
Full Name*
Age*
Date of Birth*

MonthDayYear
Residential Address*
OwnRent (Monthly Rental)Living w/ Relatives No. of Dependants
Telephone Number*
Format: (000) 000-0000.
Phone Number*

Area CodePhone Number
Tin No.*
Email*
- If EmployedIf Self Employed
- Employer*
- Address*
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Telephone Number*
  Format: (000) 000-0000.
- Monthly Salary/Allowance*
- Length of Service*
- Position*
- Job Description*
- Immediate Supervisor*
- Email Address*
- Firm*
- Address*
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Telephone Number*
  Format: (000) 000-0000.
- Nature of Business*
- Sole OwnerPartner
- Date Started*
  
  MonthDayYear
- Capital Investment*
- No. of Employees*
- Previous Employer*
- Spouse
- Name of Spouse:*
- Tin No.*
- Date of Birth*
  
  MonthDayYear
- Age*
- Email*
- Phone Number*
- If EmployedIf Self-Employed
- Employer*
- Address*
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Phone Number*
- Immediate Supervisor*
- Position*
- Monthly Salary*
- Name of Business*
- Date*
  
  MonthDayYear
- REAL PROPERTIES OWNED/ASSETS (Acquisition Cost)
- LoanSavingsCheckingTime Deposit /Special Savings
- For Loan
- Name of the Bank/Branch*
- Latest Balance*
- Account Number*
- For Savings
- Name of the Bank/Branch*
- Latest Balance*
- Account Number*
- For Checking
- Name of the Bank/Branch*
- Latest Balance*
- Account Number*
- For Time Deposit /Special Savings
- Name of the Bank/Branch*
- Latest Balance*
- Account Number*
- MONTHLY FAMILY INCOME AND EXPENSES (Husband and Wife)
- Source of Income*
- Expenses*
- I have read the privacy content and privacy policy
- Should be Empty:

DAYS FOR THE PURPOSE OF:

Spouse

REAL PROPERTIES OWNED/ASSETS (Acquisition Cost)

For Loan

For Savings

For Checking

For Time Deposit /Special Savings

MONTHLY FAMILY INCOME AND EXPENSES (Husband and Wife)