CREDIT APPLICATION FORM FOR MOTORCYCLE LOAN
Dealer:
Sales Rep:
Date:
Application No:
Please fill-up this form and submit together with other documentary requirements to facilitate processing of your loan application. All information will be treated Strictly Confidential.
Requirements:
COE
Valid ID
Company ID
Payslip (3mos)
Proof of Billing
MOTORCYCLE LOAN INFORMATION
N
I
Item Applied For:
New
Make:
Yamaha
Honda
Kawasaki
Suzuki
Repo
Unit Model:
Color:
Accessories:
Selling Price:
Downpayment:
Amt Financed:
Term:
PERSONAL INFORMATION
Last Name
First Name
Middle Name
Gender
Education
Male
Nationality
Birthday
Birth Place
Mobile Number
Phone Number
Email Address
Elementary
Highschool
College
Post Grad
Female
No. of
Dependents
Civil Status
Single
Married
Widowed
Separated
Residential Status
Current Address
Length of Stay
Yrs
Months
Permanent Address
Length of Stay
Yrs
Months
EMPLOYMENT INFORMATION
N
I
Work Category
Private Employee
Government Employee
Business
Farming
Remittance
OFW
Self-Employed
Pension / Retired
Others. Please Specify:
Present Employer / Business Name
Position
Monthly Income
Present Employer / Business Address
Date Hired
Employment Status
Present Employer / Business Contact Person
Contact Number
Nature of Work / Business
Previous Employer Name
Position
Monthly Income
Previous Employer Address
Length of Stay
Yrs
Nature of Work
Months
SPOUSE or CO-MAKER INFORMATION
Last Name
First Name
Middle Name
Mobile Number
Gender
Male
Nationality
Birthday
Email Address
Birth Place
Current Address
Female
Length of Stay
Yrs
Home Phone Number
Months
Employer / Business Name
Position
Monthly Income
Employer / Business Address
Date Hired
Employment Status
Employer / Business Contact Person
Contact Number
Nature of Work / Business
FINANCIAL INFORMATION
Sources of Income
Salary
Business Income
Regular Remittances
Pension
Deposit/Investment
TODA/Pasada
Others:
Total
Living Expenses
Food
House Rent
Electricity
Water
Internet
Cellphone Load
Transportation
Medical
Others
Total
Php
Php
Php
Php
Php
Php
Php
Php
Php
Php
Loan / Payment Obligations
Housing Loan Php
Personal Loan Php
Salary Loan
Php
Auto Loan
Php
Cash Loan
Php
SSS Loan
Php
Pag-Ibig Loan Php
Credit Card
Php
Others
Php
Total
Php
Php
Php
Php
Php
Php
Php
Php
Php
Php
Php
PERSONAL and CREDIT INFORMATION
Name of Children / Dependents
Age
School
Course
Year/Grade
1.
2.
3.
Relative Not Living With You
Address
Relationship
Telephone
Character References
Address
Relationship
Telephone
1.
2.
1.
2.
Credit References
Address
Telephone
Type of Loan
Maturity Date
Monthly Payment
Outstanding Balance
1.
2.
3.
Credit Card/s From
1.
2.
Credit Limit
Savings Account At
1.
2.
Current Account At
1.
2.
Last Financing By
1.
2.
CREDIT APPLICATION FORM FOR MOTORCYCLE LOAN
I hereby certify that all data and statement in this application are correct and complete, and are made for the purpose of obtaining credit, and the signatures appearing
thereon are genuine. I authorize you to obtain such information as you may require concerning the statements made in the application and that the sources to which
you may apply are authorized to provide any information relative to this application. I agree the application may remain your property whether the credit is granted or not.
Data Sharing Agreement
I hereby give my irrevocable consent and allows Summit Leasing & Finance Corporation (SLFC) to disclose or transfer all my personal data under the custody of SLFC,
its personal information controller and/or personal information processor, to SLFC's affiliates, other banks and financing companies, credit rating information agencies,
credit information service providers, personal information controllers, personal information processors, collection agencies, law firms, government agencies, suppliers
and third parties, for the purpose of processing the loan agreements, and/or collection of past due accounts, and/or other legitimate purpose as may be deemed necessary
by SLFC to effect successful settlement of account. I hereby hold SLFC, its shareholders, directors, officers, and employees free and harmless from all claims, actions or
demands under R.A. 10173 of the "Data Privacy Act of 2012" and its implementing rules and regulations, pursuant to its irrevocable consent of data sharing.
Applicant's Signature over Printed Name
STRICTLY CONFIDENTIAL FOR SUMMIT LEASING & FINANCE CORPORATION ONLY