China Trust Application Form (l)

Previous Home Address

Use black ink and complete all fields. If a field is not applicable, please write ‘N.A.’ Fax to 910-1942 ATTN: LAARNI

Lot/Blk. No.

House/Unit No.

Street Yrs./Months Yrs. at Present Address Provincial Home Address

LOA N D E TA I L S Desired Loan Amount (Subject to Bank’s approval)

Floor No./Building Name

Mos.

Subd./Compound Name

City/Province Yrs./Months Yrs. at Previous Address

Zip Code Mos.

Desired Loan Term

 12

 18 months

 24 months

 36 months

months

Lot/Blk. No.

House/Unit No.

Floor No./Building Name

Subd./Compound Name

Purpose of Loan  Appliance  Hospitalization

 Education  Balance

 Personal Consumption

Transfer

P E R S O N A L I N F O R M AT I O N Existing Loan Customer?

Yes

Middle Name

Marital Status

Present Employment Permanent?  Yes

Last Name

Ttile

 Male

 Mr.

 Mrs.

 Ms.

Date of Birth (dd/mm/yyyy)

 Female

 Single

 Married

Spouse Name

 Widowed Spouse Working?

No. of Children

Separated Yes

 No

Phone 2 Email

Part Owner?

 Yes







Private

Governme nt

Others

Nature of Business Position

 

Company Type

 No

________________ __

Rank



Employer/Business Name

 No Employer’s Address

No. of Dependents Lot/Blk. No.

Mother’s First Name Philippine Resident? Educational Attainment

Zip Code

WORK AND FINANCES

Other Name (Alias) Se x

City/Province

 No



First Name

Street Provincial Contact Number Area Phone Code 1 Mobile Fax

 Yes

Mother’s Middle Name Nationali  No ty

 College

 Others

 College

 Post

___________ _

Level SSS No.

Graduate Graduate

Floor No./Building Name

Subd./Compound Name

Mother’s Last Name

 High School

House/Unit No.

TIN No.

Street Office Contact Number Area Code

City/Province Phone 1

Phone 2

Mobile

Fax

Email

Zip Code

Previous Employment Employer/Business Name

Residence Type

Previous Employer’s Address

 Owned (Not Mortgaged)  Owned (Mortgaged)

Amortization/ Month

 Rented

Rent/Month

P____________

_ P____________

Lot/Blk. No.

House/Unit No.

Floor No./Building Name

Fill out this application form completely and email back with requirements at [email protected]

Subd./Compound Name

Mobile

Fax

Email

Yrs./Months at Yrs. Mos. Yrs./Months at Yrs. Present Previous Company Company Monthly Income and Expenses (based on one month payslip) Basic Allowanc Deductio e n

BASIC REQUIREMENTS Mos.

 Photocopy of ID issued by the employer with photo and signature  Photocopy of one (1) month latest pay slip (original copy may be required prior to loan release)

S P O U S E D E TA I L S

 Other documents (may be required from the applicant to process the loan)

Employer/Business Name Designation/Title/ Rank

Department

Office Contact Number Area Code

Phone 1

Phone 2

Mobile

Fax

Email

All applicants with incomplete information and lacking requirements will not be processed. Any alteration requires the full signature of the applicant. Upon approval, applicants will be required to issue postdated checks for payment. Post-dated checks should be under the name of the borrower. Handling Fee: P1,500.00 (automatically deducted from loan proceeds)

O T H E R D E TA I L S Bank References Bank Name

 Completely filled out application form  Photocopy of latest ITR/form 2316

Branch

Account Type

Account Number

___________________ __

____________ _

____________ _

____________________ __

___________________ __

____________ _

____________ _

____________________ __

___________________ ____________ ____________ ____________________ __ _ _ __ Credit Card Owned Credit Card Issuer’s Name Member Card Card Limit No. Since Expiry (mm/yyyy) (mm/yyyy )

NO FEE IS COLLECTED BY THE BANK OR ANY REPRESENTATIVE UPON APPLICATION.

U N D E RTA K I N G S / AU T H O R I Z AT I O N I hereby certify that all information herein and in all supporting documents submitted with this application, are true and correct. I hereby authorize the bank and/or its representative to verify any and all information furnished by me including previous credit transactions with other institutions. In this connection, I hereby waive any and all statutory and regulatory provisions governing confidentiality of such information if applicable. I fully understand that any misrepresentation or failure to disclose information on my part as required in this application, may cause the disapproval of my application.

____________ _

________________ _

___________ _

__________ _

__________ _

Upon acceptance of my application, I legally bind to the terms and conditions of Chinatrust including but not limited to joint and several liability for all charges, fees, and obligations incurred, and shall execute the necessary documents.

____________ _

________________ _

___________ _

__________ _

__________ _

In case of disapproval of my loan application, I understand that the bank is not obligated to disclose the reasons for such disapproval.

____________ ________________ _ _ Personal Reference Name

___________ _

__________ _

__________ _

Landline

Mobile Number

A_______________________ _

_____________________ __

_____________________ __

B_______________________ _

_____________________ __

_____________________ __

Once I have received the loan proceeds, either via Manager's Check, Cash, Electronic Fund Transfer or the Cash Card, at the Bank's options, I am deemed to have fully examined the Documents and have waived any and all objections thereto.

__________________________ ___________ __ _ Applicant’s Printed Name and Signature

C_______________________

_____________________

_____________________

F O R B A N K U S E O N LY

Fill out this application form completely and email back with requirements at [email protected]

Date