TMP-LO-52 PHONE NO.

NATURE OF JOB / BUSINESS LENGTH OF SERVICE TERMS AND CONDITIONS TERMS AND CONDITIONS

SUPPLIERS (self-employed applicants) I fully understand that the contact information protection, updating or modification, retrieval,
HOME LOAN APPLICATION FORM
SPOUSE/ CO-MAKER INFORMATION
NAME ADDRESS PHONE NO.
provided above shall be used by the Bank for any consultation, use, consolidation, blocking, erasure
NAME (Last Name, First Name, Middle Name) and all correspondences unless I otherwise notify or destruction; (iii) third parties engaged by the Bank
APPLICANT INFORMATION
the Bank. or by its subsidiaries or affiliates for the purpose(s)
NAME (Last Name, First Name, Middle Name) GENDER RELATIONSHIP WITH BORROWER GENDER
of direct/indirect marketing to offer selected
Aquino Mary Jane Pagsolingan Male Female Male Female
2. Pursuant to Republic Act No. 9510 otherwise products and services which may interest me unless
PLACE OF BIRTH DATE OF BIRTH DATE OF BIRTH PLACE OF BIRTH
known as “the Credit Information System Act” and specifically instructed otherwise in writing; (iv)
Pangasinan November 16, 1966 LOAN DETAILS
its Implementing Rules and Regulations, I insurers, insurance brokers or providers of deposit
MOTHER'S MAIDEN NAME NATIONALITY
Filipino Dual Citizen
LOAN AMOUNT TERM OF LOAN
acknowledge that the Bank is mandated to submit or credit protection or protection against all kinds of
Maria Lolita Padlan Pagsolingan 1,604,584.80
Foreigner or disclose my basic credit data to the Credit risk; or (v) such other persons or entities the Bank
NATIONALITY
Filipino Dual Citizen
EMPLOYER / BUSINESS POSITION / EMPLOYMENT STATUS PROPERTY ADDRESS
Information Corporation (CIC) as well as any may deem as having authority or right to such
Amaia Scapes Trece Martires Cavite 1 Blk 25 Lot 8
Foreigner updates or corrections thereof, and share said disclosure of information as in the case of regulatory
CIVIL STATUS EMPLOYER / BUSINESS ADDRESS TYPE OF PROPERTY
Widowed Separated Condominium Residential Lot Townhouse basic data with other lenders authorized by the agencies, governmental or otherwise, which have
Single Married Others
House & Lot Others: CIC, credit reporting agencies duly accredited by required such disclosure from the Bank. I agree to
TAX IDENTIFICATION NO. SSS / GSIS NO. PHONE NO. NATURE OF JOB / BUSINESS YRS IN JOB / BUSINESS
131-065-098 CRN 00036874797-7 SELLER / DEVELOPER / BROKER CONTRACT PRICE the CIC and financial service providers. I consent hold the Bank, its affiliates, subsidiaries and third
Amaia Scapes Trece Martires 1,782,872.00 to the processing, sharing and/or transferring of party service providers free and harmless from any
PRESENT HOME ADDRESS (No., Street, Village/Subdivision/Barangay, Town/City, Province, Zip Code)
B20 L16 Lychee St. Villa Luisa Homes, Dasmarinas Cavite 4114
FINANCIAL DATA
This is to authorize Union Bank of the Philippines to conduct an appraisal of the Real my Personal Data as this term is defined under liability that may arise from, or in connection with,
Estate property / properties located in the address / addresses given above:
Monthly Income
Borrower Spouse Republic Act No. 10173 otherwise known as the the collection, processing, use, storage, updating
OWNERSHIP LENGTH OF STAY 34000 Contact Person: Phone No.:
Owned Living with Relatives Rented 20 years
Salary
Commission / Incentives
“Data Privacy Act of 2012”, its Implementing and transfer/ disclosure/ sharing/ communication of
Other Income ATTORNEY - IN - FACT Rules and Regulations and all other issuances of my personal information pursuant to, and in
PERMANENT HOME ADDRESS (No., Street, Village/Subdivision/Barangay, Town/City, Province, Zip Code)
B20 L16 Lychee St. Villa Luisa Homes, Dasmarinas Cavite 4114 Less: Expenses NAME (Last Name, First Name, Middle Name) the National Privacy Commission and hereinafter compliance with the consent given by me under this
HOME PHONE NO. OFFICE PHONE NO. MOBILE NO.
Living / Utilities
Educational / Medical
referred to as the “Applicable Data Privacy Agreement.
0917-541-8466 Amortization RELATIONSHIP WITH BORROWER PHONE NO. Regulations”, or otherwise, relating to my account
EMAIL ADDRESS NO. OF DEPENDENTS AGE/S OF DEPENDENTS
Monthly Disposable Income 26000 (s) without need of notice, to (i) government Nary Jane Aquino 4/27/2021
janeaquino16@yahoo.com CREDIT INFORMATION ADDRESS regulatory agencies, credit information/ Signature of Applicant / Date
WOULD YOU LIKE TO AVAIL OF A UNIONBANK CREDIT CARD? DEPOSIT ACCOUNTS / PLACEMENTS investigation companies, financial institutions,
YES NO BANK / BRANCH ACCOUNT NUMBER DATE OPENED ACCOUNT TYPE TERMS AND CONDITIONS credit bureaus, other banks, credit card
EMPLOYMENT INFORMATION UCPB 1. I authorize UnionBank of the Philippines companies, loyalty program partners, consumer Signature of Spouse or Co-maker / Date
(“Bank”) to notify me, through text or e-mail reporting or reference agencies such as Credit
SOURCE/S OF FUNDS
Salary Commission/ Fees Others messages, of any and all reminders, notices, Card Association of the Philippines, Bankers
Business Remittance
marketing materials, promotions, loan offerings Association of the Philippines, Credit Information FOR BANK'S USE ONLY
NAME OF EMPLOYER / BUSINESS POSITION / EMPLOYMENT STATUS CREDIT CARDS
and all other Bank offerings and product Corporation, and the Transunion Credit Bureau for REFERRED / ENDORSED BY:
VALIDITY /
Duty Free Philippines Division Secretary ISSUER ACCOUNT NUMBER
EXPIRY
CREDIT LIMIT
updates. I understand that the Bank may use the purpose of credit investigation, consumer
FORM OF BUSINESS
my personal information to pre-qualify me for reporting, or for reports of my credit history and
Sole Proprietorship Partnership Corporation
other product offerings. I confirm that I am solely account updates; (ii) third persons, correspondent Signature over Printed Name / Date

EMPLOYER / BUSINESS ADDRESS

responsible for the security of my cellphone and banks, service providers and entities, as the Bank
Fiestamall, EHA Bldg. Ninoy Aquino Ave. Paranaque City 1700
e-mail and thus hereby hold the Bank free and deems necessary, to enable the Bank to service POSITION UNIT / BRANCH

PHONE NO. NATURE OF JOB / BUSINESS YRS IN JOB / BUSINESS REFERENCES harmless from any and all damages, causes of my account/s and to provide all the existing
+632 8552-4337 logistics 27 years
TRADE REFERENCES (self-employed applicants) action and liabilities if the information contained features of my account/s, the Bank products, REMARKS / SPECIAL INSTRUCTIONS

PREVIOUS EMPLOYER POSITION / EMPLOYMENT STATUS NAME ADDRESS PHONE NO. in the electronic or text notification is, for services, facilities and channels, and any future
whatever reason, by any means accessed by enhancements thereto or to assist the Bank in the
EMPLOYER / BUSINESS ADDRESS
any person other than myself. processing of my data, including its collection,
recording, organization, storage, management,