Customer Information Sheet [vc_row][vc_column] UNIT APPLIED * MOTORCYLE : SOLO MODELMOTORCYLE : TRICYCLE MODELAPPLIANCEFURNITURECOMPUTER & IT PRODUCTS * Place of use * Purpose Brand Model Down Payment Monthly Installment Terms in Month Customer Code NewRepeatWith Existing Account APPLICANT INFORMATION * Last Name * First Name * Middle Name * Birthday * Age * Nationality * Religion * Home Address * Length of stay Previous Address Reason for Leaving Length of stay Residence RentedOwn-MortgageLiving with parents/relativesUsed free Name of Landlord if rented Provincial Address * No. of Dependents * Marital Status SingleMarriedWidow/erSeparated * Cellular Phone No. Tel Nos. at home address * Email Address * TIN No. * SSS/GSIS No. Driver’s License No. SPOUSE INFORMATION (Parents, if single) * Last Name * First Name * Middle Name * Birthday * Age * Nationality Religion * Home Address * Length of stay * Status Legally MarriedLive-in Partner Years known to Applicant Tel Nos. at Residence Cellular Phone No. * Email Address TIN No. SSS/GSIS No. EMPLOYMENT PRINCIPAL APPLICANT EmployedBusinessOFWFarming * Name of Employer/Business * Nature of Business * Employer/Business Address * Contact Nos. Employment Status, if employed * Position * Gross Income * Years Connected SPOUSE (Parent, if single) EmployedBusinessOFWFarming * Name of Employer/Business * Nature of Business * Employer/Business Address * Contact Nos. Employment Status, if employed * Position * Gross Income * Years Connected IMMEDIATE FAMILY INFORMATION If married - Name of Children & Parents If single – Name of Brothers, Sisters & Parents Age Relations If studying – name of school. If working – name of company or Home Address Contact Nos. INCOME AND EXPENSES Source of Income Employment ₱ Employment (Spouse) ₱ Own Business / Self-employed ₱ Farming ₱ Remittance ₱ Tricycle Operation ₱ Others ₱ TOTAL ₱ Expenses Rent ₱ Tel., Light, Water, Cell phone, Internet, Cable ₱ Household / Living ₱ Education ₱ Fuel / Oil / Transportation ₱ Loans / Amortization ₱ Others ₱ TOTAL EXPENSES ₱ PERSONAL REFERENCES (Not related to applicant) 1.) * Name * Address * Profession / Occupation * Contact No. 2.) Name Address Profession / Occupation Contact No. PERSONAL PROPERTIES / HOUSEHOLD POSSESSIONS Motor Vehicle/Appliances Make/Model Year Acquired Mortgaged to Monthly Amortization No. of Months to pay BANK INFORMATION * Type of Deposit (Current) * Name of Bank * Address * Ave. Mo. Balance ₱ * Type of Deposit (Savings) * Name of Bank * Address * Ave. Mo. Balance ₱ REAL ESTATE PROPERTIES OWNED Location Area (sq. m / hectares) Market Value Mortgaged to No. of years to pay Monthly Amortization * Type ResidentialAgriculturalTitledUntitled Δ[/vc_column][/vc_row]
