Application Form

RURAL BANK OF LIMAY

LATEST 2X2 PHOTO (cut-out not acceptable)

APPLICATION FOR ___________________________ LOAN (to be filled up by Applicant)

INSTRUCTION: Please fill up the blanks properly. Write legibly, print or typwrite. If there is anything that is not clear to you regarding any question and/or item, don’t hesitate to approach any rural bank representative to assist you. Application shall be accompanied by collateral documents, if applicable, offered as security for the loan. YOUR PERSONAL DATA (APPLICANT) LAST NAME

AGE:

________

Date of Birth : ____________

CIVIL STATUS FIRST NAME

EDUCATIONAL ATTAINMENT

SINGLE

SEPARATED

HIGH SCHO

UNDERGRAD COLL

MARRIED

WIDOWED

COLLEGE

GRADUATE SCHOOL

MIDDLE NAME HOME OWNERSHIP

RESIDENCE ADDRESS:

OWNED

WITH PARENTS/RELATIVES

RENTED

MORTGAGE

BUSINESS ADDRESS:

OCCUPATION/EMPLOYMENT LENGTH OF SERVICE GOVERNMENT

YEARS

PRIVATE

MONTHS

PERMANENT

COTERMINUS

CONTRACTUAL

ELECTED

YOUR SPOUSE LAST NAME OCCUPATION: FIRST NAME

NO. OF DEPENDENTS DATE OF BIRTH:_____________________________

MIDDLE NAME NAME OF DEPENDENTS:

AGE

I. PURPOSE OF THE LOAN APPLIED FOR:

EDUCATION LEVEL/SCHOOL

Amount Applied_____________

Date Needed________________

SPECIFIC PURPOSE

MOTORCYCLE ACQUISITIO ____________________________________________________________ DESCRIPTION OF UNIT:_________________________________________________________________ II. YEARLY INCOME AND EXPENSES: SOURCES OF INCOME

AMOUNT

(ITEMIZED)EXPENSES

AMOUNT

CO-MAKER LAST NAME

FIRST NAME

MIDDLE NAME

ADDRESS:

Date of birth

Occupation/Employment

Tel. #

I/We hereby certify that all information furnished herein are true and correct to the best of my/our knowledge. The above information are given for the purpose of obtaining credit from and hereby authorize GM Bank, Inc. (A Rural Bank) to obtain information concerning any statement made herein. I understand that should my/our application be approved, notarial and other legal fees pertaining to the registration of mortgage of property shall be for my/our account. I/We agree that all documents shall remain the property of the rural bank whether or not the requested facility is granted. SIGNATURE VERIFIED

SIGNATURE VERIFIED Signature of Borrower over printed name /Date

Signature of Spouse over printed name

Signature of co-maker over printed name /Date

/Date

FOR BANK'S USE ONLY APPLICANT

WALK IN (GM CYCLE)

AMOUNT OF UNIT:

P ___________

AMOUNT OF APPLICATION:

P ___________

TERM:

____________

INTEREST RATE (PER MO):

____________

WOULD BE AMORT:

P ___________

MICRO LOAN ACCOUNT

GM BANK CLIENT

ENDORSED BY/DATE: RECEIVED BY

: Credit Department / Date