Professional Documents
Culture Documents
Tracking No
1 2 1 0
8 2 3 3
5 2 8 2
LOAN PARTICULARS
DESIRED LOAN AMOUNT
PURPOSE OF LOAN
300,000.00
10
DESIRED RE-PRICING PERIOD (Years)
5
MODE OF PAYMENT
Salary deduction
Over-the-Counter
Post-Dated
Checks
Cash/Check
Collecting Agent
Bank
Developer
Remittance
Center
COLLATERAL
IS PROPERTY PRESENTLY
MORTGAGED?
YES
NO
0 SQM
TAX DECLARATION NO.
EXISTING
PROPOSED
No. of
STOREYS
LAND AREA
TCT/OCT/CCT NO.
DESCRIPTION OF
IMPROVEMENTS
LOT/UNIT NO.
BLOCK/BLDG NO.
TOTAL FLOOR
AREA
0 SQM
AGE OF HOUSE (For Purchase of a Residential Unit)
0 SQM
BORROWERS DATA
LAST NAME
FIRST NAME
CHAVEZ
ARIEL
NAME EXTENSION
MIDDLE NAME
CITIZENSHIP
PUNONGBAYAN
FILIPINO
SEX
MARITAL STATUS
ATTACH HERE
1X1
ID PHOTO
OF APPLICANT
Legally
Separated
Annulled
Single/
Unmarried
Married
Widow/er
if abroad)
Home
HOME OWNERSHIP
Owned
Company
Living w/ relatives/parents
Mortgaged
Rented
EMPLOYER/BUSINESS NAME (If self-employed)
YEARS OF STAY IN
PRESENT HOME
ADDRESS
EE SSS/GSIS ID No.
0278032421
Cell Phone
09157414089
LOAN ENTITLEMENT
Email Address
27
ayel.wf4@gmail.com
TIN
413155306
EMPLOYER/BUSINESS ADDRESS
OCCUPATION
Self-Employed
Employed
MONTHLY HDMF
CONTRIBUTION
YEARS IN
EMPLOYMENT/
BUSINESS
5
Employer/Business Email Address
INDUSTRY
Accounting
Activities of Private
Households as
Employers &
Undifferentiated
Production Activities
of Private
Households
Agriculture, Hunting,
Forestry & Fishing
Basic Materials
Construction
Education & Training
Electricity, Gas and
Water Supply
Extra-Territorial
Organization & Bodies
Financial Services/
Intermediation
HR/Recruitment
Technology
Transport, Storage
and Communications
Travel and Leisure
Wholesale & Retail
Trade; Repair of
Motor Vehicles,
Motorcycles,
Personal &
Household Goods
NO. OF
DEPENDENT/S
2
POSITION & DEPARTMENT
FIRST NAME
NAME EXTENSION
MIDDLE NAME
CITIZENSHIP
YEARS IN EMPLOYMENT/
BUSINESS
0
OCCUPATION
Self-Employed
Employed
Unemployed
EMPLOYER/BUSINESS ADDRESS
INDUSTRY
Accounting
Activities of Private Households as
Employers & Undifferentiated
Production Activities of Private
Households
Agriculture, Hunting, Forestry &
Fishing
Basic Materials
Construction
Education & Training
Electricity, Gas and Water Supply
Extra-Territorial Organization & Bodies
Financial Services/ Intermediation
HR/Recruitment
Health and Social Work;
Health and Medical Services
Life Sciences
Management
Manufacturing
Media
Mining and Quarrying
Other Community, Social & Personal
Service Activities
Public Administration & Defense;
Compulsory Social Security
/
BUSINESS TEL. NO.
Technology
Transport, Storage and Communications
Travel and Leisure
Wholesale & Retail Trade; Repair of Motor
Vehicles, Motorcycles, Personal &
Household Goods
(Revised/August 2012)
PRINCIPAL BORROWER
SPOUSE
14,000.00
6,000.00
0.00
0.00
0.00
2,000.00
22,000.00
TOTAL
0.00
BDO
BRANCH/ADDRESS
TYPE OF ACCOUNT
AYALA, ALABANG
SAVINGS
ISSUER NAME
CARD EXPIRY
(mm/yyyy)
CREDIT LIMIT
TYPE OF PROPERTY
ACQUISITION COST
MARKET VALUE
MORTGAGE
BALANCE
RENTAL INCOME
Security
Security
Security
Type
Maturity Date
Amount/Balance
Mo. Amortization
Type
Maturity Date
Amount/Balance
Mo. Amortization
Type
Maturity Date
Amount/Balance
Mo. Amortization
MISCELLANEOUS
(Answer the following questions with YES or NO. If your answer is YES, please elaborate on the details as required)
Yes
No
Was your bank account ever closed because of mishandling or issuance of bouncing checks? If yes, please indicate the banks name, nature amount and date.
Yes
No
BANK/FINANCIAL INSTITUTION
PURPOSE
SECURITY
HIGHEST
AMOUNT OWED
PRESENT
BALANCE
DATE
OBTAINED
DATE
FULLY PAID
ADDRESS
TEL. NO.
CHARACTER REFERENCES
NAME
ADDRESS
TEL. NO.
CERTIFICATION
I/We certify that the foregoing information/statement is to my/our knowledge, true, correct, complete, and updated. The signature/s appearing below is/are
genuine. I/We authorize Pag-IBIG Fund to conduct verification on all the details stated on this document as well as the other documents I/We have submitted from
whatever source that it may consider appropriate to establish its correctness, validity, and authenticity.
I/We hereby agree that any misrepresentation of a material fact is a ground for disapproval of the application, cancellation of the loan, and shall be a cause for
the total outstanding obligation to be due and demandable and shall be subject to other sanctions provided in existing Pag-IBIG guidelines. I/We agree to notify PagIBIG Fund of any material change affecting the information contained herein. I/We agree that all information obtained by Pag-IBIG Fund shall remain its property
whether or not the loan is granted.
I/We further agree to pay Pag-IBIG Fund a non-refundable sum of One Thousand Pesos (P1,000.00) as processing/filing fee to be paid upon filing of the loan
application and Two Thousand Pesos (P2,000.00) to be paid upon loan takeout. I/We understand that should my/our application be approved, notarial and all other
fees pertaining to the registration of mortgage on property shall be for my/our account.
____________________________________
SIGNATURE OF BORROWER
____________________________________
SIGNATURE OF SPOUSE
____________________________________
DATE
____________________________________
DATE