SME
Business
Loan
Application
Form

CHIQU
Lending
Corp.

LOAN
DETAILS
Desired
Loan
Amount
(Php)꞉ Desired
Payment
Term꞉ Mode
of
Loan
Release꞉
2
months Cash
withdrawal
from
CHIQU
Automated
Lending
Kiosks.
3
months Bank
account
4
months Gcash
or
Paymaya
Loan
Purpose꞉
Investment
or
Upgrade
in
Systems
and
Technology Machine
and/or
Equipment
Repair
Renovation
of
Office
/
Warehouse Advertising
Campaign
Employees’
Training
Program Additional
Working
Capital
Loan
Balance
Transfer Purchase
of
Raw
Materials
and/or
Inventory,
please
specify

_________________

BORROWER’S
INFORMATION
First
Name꞉ Middle
Name꞉ Last
Name꞉

Mother’s
Maiden
Name
 Date
of
Birth
(MM/DD/YYY) Age Place
of
Birth Source
of
Funds

Civil
Status Gender Educational
Attainment

Single Married Male High
School Vocational Others꞉

____________
Legally
Seperated Widow
/
Widower Female College Postgraduate _________________
Home
Phone
Number Mobile
Phone
Number Facebook
account E‑mail
address

Present
Home
Address (Lot
Blk
No.,
House/Unit
No.,
Floor
No./Building
Name,
Street,
Subdivision,
City/Province,
Zip
Code) Owned

Living
with
Relatives/Parents
Company
Provided
Renting
for
Php

________/mo.
Mortgaged
with
__________
Length
of
Stay꞉
____
Years
____
Months Amortization꞉
Php
_______/mo.
Permanent
Home
Address (Lot
Blk
No.,
House/Unit
No.,
Floor
No./Building
Name,
Street,
Subdivision,
City/Province,
Zip
Code) Owned
Living
with
Relatives/Parents
Company
Provided
Renting
for
Php

________/mo.
Mortgaged
with
__________
Length
of
Stay꞉
____
Years
____
Months Amortization꞉
Php
_______/mo.
Car
Ownership Motorcycle
Ownership
Owned
/
Unencumbered No.
of
cars꞉
Owned
__
Mortgaged
___ Owned
/
Unencumbered No.
of
cars꞉
Owned
__
Mortgaged
___
Mortgaged Monthly
Amortization
Php


_______ Mortgaged Monthly
Amortization
Php


_______
Company
Provided Mortgaged
with
______________ Company
Provided Mortgaged
with
______________
None None

SPOUSE
AND
FAMILY
INFORMATION
First
Name꞉ Middle
Name꞉ Last
Name꞉

Employer
/
Business
Name Lenght
of
Service Position

Date
of
Birth
(MM/DD/YYY) Office
Phone
Number Mobile
Phone
Number

PERSONAL
REFERENCES
Reference
Name Address Mobile
Phone
Number Relation
 SME
Business
Loan
Application
Form
CHIQU
Lending
Corp.

LOANS
WITH
BANKS
AND
FINANCIAL
INSTITUTIONS
Name
of
Bank
/
F.I Type
of
Loan Loan
Amount Type
of
Loan Monthly
Amortization Outstanding
Balance

BUSINESS
INFORMATION
Business
Name

Business
Address (Lot
Blk
No.,
House/Unit
No.,
Floor
No./Building
Name,
Street,
Subdivision,
City/Province,
Zip
Code)

Form
of
Organization Number
of
Employees Position Major
Products
/
Service
Offered

Corporation
Partnership
Sole
Properietorship
Date
Established
(MM/DD/YYY)
Percentage
Ownership
(%)
Regular
_________ Owner
Probationary
______ Chairman
Contractual
_______ President
Project‑based
______ Vice
President
Director
Years
in
Business
Operation
______
years
_____
months
SSS
/
GSIS
Number
General
Partner
Limited
Partner
Others,
please
 Name
of
Business
specify

______
___________
Lenght
of
Service
______
years
_____
months
Tax
Identification
Number
(TIN)

Office
Phone
Number Fax
Number Office
E‑mail
Address

Total
Business
Assets
Size Business
Income Business
Website
or
FB
Page

Daily

________ Monthly
Php
____________________ Weekly
_______ _________
I/We
certify
that
all
information
herein
and
herewith
furnished
are
all
in
respects
true
and
correct.

It
is
also
agreed
that
the
CHIQU
may
inquire
into
their
correctness
by
the
methods
it
may
deem
proper
to
use
and
that
this
document
shall
remain
the

property
of
CHIQU
LENDING
CORP.
whether
or
not
the
loan
is
granted.
I/We
hereby
acknowledge
and
authorize꞉
1)
the
regular
submission
and
disclosure
of
my/our
basic
credit
data
(as
defined
under
Republic
Act
No.
9510

and
its
implementing
Rules
and
Regulations)
to
the
Credit
Information
Corporation
(CIC)
as
well
as
any
updates
or
corrections
hereof;
and

2)
the
sharing
of
my/our
basic
credit
data
with
other
lenders
authorized
by
the
CIC,
and
credit
reporting
agencies
duly
accredited
by
the
CIC.

Signature
of
Applicant
/
Authorized
Signatory
over
Printed
Name
/
Date


REQUIREMENTS Referral
Information (optional)

Duly
filled‑out
and
original
signed
application
form Name꞉
Photocopy
of
two
(2)
valid
government
issued
ID
with
three
(3)
specimen
signatures
Proof
of
residence
address,
either
of
the
following꞉
Latest
one
(1)
month
proof
of
billing
(i.e.
utility
bill
or
lease
contract
under
applicant’s
name)
Latest
one
(1)
month
proof
of
billing
(i.e.
utility
bill
or
lease
contract
under
business’s
name)

 Mobile
number꞉
SEC/DTI
Certificate
of
Registration


Latest
Business
Permit
Certificate
of
Lease
Copy
of
Stall/Kiosk
Lease
Agreement Relation꞉
Note꞉
Other
documents
that
may
be
required
to
process
the
loan.