70 - Motorcentral Los Baños APPLICATION

We are located @ 5291 Nat'l Rd. Brgy. Maahas Los Baños, Laguna 4030
You may also contact us at: 0946 651 9965
MOTORCENTRAL CREDIT APPLICATION
BRANCH:*
Facebook NAME:*
BRAND*
HONDA*
YAMAHA*
KAWASAKI*
SUZUKI*
BAJAJ*
KYMCO*
LCP
Specific unit color*
DOWN PAYMENT*
AMOUNT FINANCE
MONTHLY AMORTIZATION
TERMS OF LOAN*
TOTAL PRICE
(All informations will be treated CONFIDENTIAL)
PERSONAL DATA
First Name*
Middle Name
Mother's Maiden Name
Last Name*
Date of Birth*

MonthDayYear
Date
Age*
Birth Place*
Civil Status*
Citizenship*
Contact Number*
E-mail/Gmail/Facebook Name*
TIN NUMBER (OPTIONAL)
Present Address*
Length of Stay*
Provincial Address
Length of Stay
OwnedRentedProvidedAmortized
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
Present Address
Length of Stay in Work
Position
NAME OF EMPLOYER (leave blank if Not Applicable)
ADRESS OF WORK / AGENCY
MONTHLY SALARY (leave blank if Not Applicable)
Tel./Cel No.
NAME OF DEPENDENT (leave blank if Not Applicable)
RELATIONSHIP TO DEPENDENT
AGE OF DEPENDENT
NAME OF DEPENDENT (leave blank if Not Applicable)
RELATIONSHIP TO DEPENDENT
AGE OF DEPENDENT
APPLICANT EMPLOYMENT DETAILS
APPLICANT POSITION*
ASSIGNED WORK*
DATE HIRED:*

MonthDayYear
Date
LENGTH OF STAY IN WORK*
NAME OF EMPLOYER*
ADDRESS 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
From Whom
Remittance
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*
Signature (Buyer)

Clear
FULL NAME*
Filled up date*

MonthDayYear
Date
LIST OF REQUIREMENTS

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
2 VALID ID WITH 3 SIGNATURE FRONT*

Cancelof
2 VALID ID WITH 3 SIGNATURE BACK*

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

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

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

Cancelof
How's your experience in filling-out the ONLINE APPLICATION FORM?*
Comment about application form
I certify that all information I have disclosed in this Credit Application are true and correct to my own personal knowledge. I also authorize Motorcentral Finance Corporation to collect and process my personal data and to perform any related credit investigation procedures incidental thereto my motorcycle loan application, in compliance with R.A. No.10173 (Data Privacy Act).
Application Result
Sales Partner / Agent Code / Sales Tagging
Please verify that you are human*
Should be Empty:

MOTORCENTRAL CREDIT APPLICATION

PERSONAL DATA

SPOUSE DATA

APPLICANT EMPLOYMENT DETAILS

OTHER SOURCE/S OF INCOME / REMITTANCE

Character Reference