PREMIER AUTOTECK INC.

( KIA ORTIGAS )
APPLICATION FOR AUTO LOAN
BRANCH : DEALER :
ORTIGAS PREMIER AUTOTECK

SALESMAN :

ALVIN BANSIL

Applicants Photo

DETAILS OF APPLICATION
Unit Applied Net Cash Price Your Name First Civil Status Sex Home Address Previous Address Prov'l. Address Home Tel. Res. Status Fully Owned If Mortgaged : Bank If Rented : Monthly Rental No. of Cars Owned Employed Employer/Business Business Address Nature of Business Self-Employed No. of Cars Mortgaged Bank Mortgaged Professional Yrs. w/ Present Employer/Business Position Tel. No. Monthly Income Other INcome Mortgaged Cellphone No. Rented Living w/ Parents/Relatives Monthly Amortization Married Male Middle Single Female Last Widowed Nationality Separated TIN Yrs. Stay Yrs. Stay Downpayment Year Amt. Financed Term Date of Birth mm dd yy Mos.

PERSONAL INFORMATION

OCCUPATION & INCOME

INFORMATION ON SPOUSE
Name First Employer/Business Business Address Nature of Business Middle Last Date of Birth mm Position Yrs. w/ Employer/Business Business Tel. No. Monthly Income Name dd yy

INFORMATION ON CHILDREN
Name School/Employer School/Employer

BANK ACCOUNTS / LOANS / CREDIT CARDS

Financial Institution & Branch Type of Account Monthly Amortization (if loan) Telephone Number

TRADE REFERENCES
Customer/Contact Person Telephone Number Supplier/Contact Person Telephone Number

PERSONAL REFERENCES
Name Address Telephone Number

I/We certify that all the above information are true and correct to the best of my/our knowledge.I /We authorize you to verify and investigate the above information from whatever sources you may consider appropriate.
FOR BANK USE ONLY

CREDIT STATUS Date IC: APPROVED

___________________________ Signature of Applicant Date

DECLINED

CONDITIONS

Recommended by: Officer Code

Approved by: Officer Code