FLH060

HDMF HOUSING LOAN APPLICATION

LOAN PARTICULARS
PURPOSE OF LOAN MODE OF PAYMENT Amount of Loan Applied For
Additional Loan Purchase of HDMF acquired properties
Bank
Home Improvement Purchase of a Residential Unit (House & Lot) P
House Construction Purchase of Townhouse or Condominium Over- the- Counter
Unit inclusive of a parking slot Maturity of Loan Desired (Years)
Purchase of a Fully Developed Lot Salary Deduction
Purchase of Lot and Construction Refinancing of an existing mortgage loan
of a Residential Unit
COLLATERAL
Property Location (Street, Municipality, Province) Is property presently mortgaged? DESCRIPTION OF
EXISTING PROPOSED
YES NO IMPROVEMENTS
No. of
Name of Developer/Registered Title Holder Land Area STOREYS
SQM TOTAL FLOOR
AREA SQM SQM
TCT/OCT/CCT No. Tax Declaration No. Lot/Unit No. Block/Bldg. No. AGE OF HOUSE (For purchase of a residential unit)

BORROWER'S DATA
Last Name First Name Middle Name HDMF ID No. Date of Birth (mm/dd/yy) Gender
M F
ATTACH HERE
Permanent Home Address (No., Street, City, Municipality, Province) ZIP Code Home Tel. No. 1" x 1"
ID PHOTO
OF APPLICANT
Present Home Address (No., Street, City, Municipality, Province) E-mail Address Civil Status
Single Legally Separated
Residence Address (Abroad) Years of Stay Married Annulled
Widow/er For HDMF USE ONLY
Home Ownership EE SSS/GSIS ID No. Business Tel. No. MONTHLY HDMF
Owned Company Living w/ relatives/parents CONTRIBUTION
Mortgaged Rented at P
/ _________/mo.
Company/Employer/Business Name (if self-employed) TIN Mobile Phone No. P
LOAN ENTITLEMENT
Company/Employer/Business Address Years in Employment/Business Philippine Citizen?
Yes No P
Nature of Business Position & Department No. of Dependent/s CERTIFIED BY

Preferred Mailing Address

SPOUSE PERSONAL DATA

Last Name First Name Middle Name Date of Birth (mm/dd/yy) TIN

Company/Employer/Business Name (If self-employed) Company/Employer/Business Address

Nature of Business Position & Department Business Tel. No. Years in Employment/Business

BANK ACCOUNTS (Indicate your 3 most active)

BANK BRANCH/ADDRESS TYPE OF ACCOUNT ACCOUNT NO. DATE OPENED AVE. BALANCE

CREDIT CARDS OWNED (Indicate your 3 most active)

CARD COMPANY BANK ISSUER CREDIT LIMIT CARD NO. EXPIRY DATE

REAL ESTATE OWNED

TYPE OF TCT NO. ACQUISITION MARKET MORTGAGE RENTAL
LOCATION
PROPERTY COST VALUE BALANCE INCOME

OUTSTANDING CREDITS/LOAN AVAILMENTS

Creditor & Address Security Type Maturity Date
Amount/Balance Mo. Amortization

Creditor & Address Security 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.)
MISCELLANEOUS
Are there (Answer
past or pending cases against you? the Yes
following
No questions with YES or NO. If your answer is YES, please elaborate on the details as required.)
If yes, please indicate the nature, plaintiff, amount involved and the status.
Do you have past due obligations? If yes, please indicate the creditor's name, nature, amount involved and due date.
Yes No
Was your bank account ever closed because of mishandling or issuance of bouncing checks? If yes, please indicate the bank's name, nature, amount and date.
Yes No
 FINANCIAL INFORMATION
ASSETS AND LIABILITIES MONTHLY INCOME AND EXPENSES
ASSETS BORROWER SPOUSE/OTHERS
CASH ON HAND/BANK _____________________ INCOME
SALARIES __________________ _________________
STOCKS AND BONDS _____________________
ALLOWANCES __________________ _________________
REAL ESTATE _____________________
COMMISSIONS __________________ _________________
MOTOR VEHICLES OWNED _____________________
RENTAL INCOME __________________ _________________
OTHERS (Specify) _____________________
OTHERS (Specify) __________________ _________________
_____________________
_____________________ __________________ _________________

TOTAL ASSETS __________________ _________________

GROSS MONTHLY INCOME __________________ _________________
LIABILITIES
WITHHOLDING TAX __________________ _________________
UNSECURED LOANS _____________________
COMBINED NET MONTHLY INCOME
OTHERS (Specify) _____________________
_____________________ EXPENSES (Combined for Borrower/Spouse/OTHERS)
_____________________ Living and Utilities _________________
TOTAL LIABILITIES Education _________________
Transportation _________________
NET WORTH (ASSETS - LIABILITIES) Loan Amortization _________________
Others (Specify) _________________
_________________
_________________
Combined Monthly Expenses _________________
Combined Net Disposable Income

LOAN ENTITLEMENT

LOAN AND CREDIT REFERENCES

HIGHEST PRESENT DATE DATE
BANK/FINANCIAL INSTITUTION ADDRESS PURPOSE SECURITY
AMOUNT OWED BALANCE OBTAINED FULLY PAID

TRADE REFERENCES (For Self-Employed Only)

NAME OF SUPPLIER ADDRESS TEL. NO.

CHARACTER REFERENCES
NAME ADDRESS TEL. NO.

CERTIFICATION
I/We certify that the foregoing information/statement are to the best of my/our knowledge, true, correct and complete, and I/We hereby
agree that any misrepresentation of a material fact is a ground for disapproval of the application, cancellation of the loan, or foreclosure
of the mortgage as the case may be. I/We agree to notify HDMF of any material change affecting the information contained herein. I/We
agree that all information obtained by HDMF shall remain its property whether or not the loan is granted.

I/We further agree to pay HDMF the non-refundable sum of One Thousand Pesos (P1,000.00) as processing/filing fee to be paid
upon filling 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 of property shall be for my/our account.
The signature/s appearing below is/are genuine.

SIGNATURE OF BORROWER SIGNATURE OF SPOUSE

DATE DATE

FOR HDMF USE ONLY

SIGNATURE OF HDMF REPRESENTATIVE NAME IN PRINT DATE RECEIVED
RECEIVED BY

THIS FORM CAN BE REPRODUCED. NOT FOR SALE