Information Request Form

Principal Borrower Complete Name:

First NameLast Name

E-mail

example@example.com

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Type of address

Lenght of stay

Civil Status

Gender

Citizenship

Number of dependents

TIN Number

Co-Borrower Complete Name:

Name

First NameLast Name

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Company/Business

Office Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Company Telephone/Business number

Lenght of stay

Monthly Net Income:

Bank Accounts

SavingsJoint AccountDollar Account

Employment type

SalarySelf-EmployedOFW

Position

Account Number

Name of Bank/Branch

Company Human Resource Email

example@example.com

2 Government Valid Id's with 3 specimen signature

Principal Signature

Company/Business Name

Office Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email Address co-borrower:

example@example.com

Company Telephone number/Business

Please enter a valid phone number.

Company Human Resource Email

example@example.com

Nature of Business:

Net Monlthy Income

Employment type

SalarySelf-EmployedOFW

Position

2 Government Valid Id's with 3 specimen signature

Co-borrower Signature

Principal and co-borrower Specific best time to call Monday-Friday office hours only.

I hereby authorize PEAK MOTORS PHILIPPINES INC. 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 the dealer's rights to its accredited bank, 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 providers. I am also aware that the details of how my personal data will be processed and the rights available to me are listed in the accredited bank's Privacy Policy Statement. If I want to access, update, or correct my personal data, or withdraw my consent, I know that I may contact the customer service of PEAK MOTORS PHILIPPINES INC. and its accredited banks.

CREDIT APPLICATION "PMPI PASAY"

PRINCIPAL BORROWER

Co-Borrower

Principal Borrower

Co-Borrower