PERSONAL LOAN APPLICATION FORM

NOTE: Print in 8.5” x 13” paper size

Documentary Requirements: 1 Valid ID • Certificate of Employment; or • Current pay slip or a copy of the latest BIR Form 2316 (W2) or ITR and Proof of Billing • For Self-Employed / Professional Applicant, refer to documentary list below.
REFERRAL Channel Source Source Code Name of Referror Unit / Branch LOAN APPLICATION NUMBER
INFORMATION
LOAN APPLICATION INFORMATION
Desired Loan Amount ________________________________ Loan Medical expenses Purchase of appliance, furniture and other household needs
In the event the desired amount cannot be granted, shall we proceed to process Education / tuition fee Vacation trip
Purpose House renovation Other personal needs
a lower loanable amount? Yes ■ No
Loan Term For Below 500k 3 6 12 18 24 ■ 36 Months Employment Type Private Professional Government Self-Employed
For 500k and above, up to 48 60 Months Nominated PNB account for loan proceeds (if approved): _____________________
Middle Name Date of Birth (mm/dd/yyyy) Place of Birth Age Gender
Last Name First Name Middle Name
Male
Female
Civil Status Citizenship Maiden Name (For Female Married Borrowers) No. of Dependents Mother’s Maiden Name
Single Widowed Annulled
Married Separated
TIN SSS /GSIS No.
Highest Educational Attainment Grade School High School College Post Graduate
PERSONAL INFORMATION

I.D. Presented No. Mobile No. Landline No. Email Address

Present Home Address (Unit No/ Floor, Building Name, Building/House No., Street, Barangay, City/Municipality, Province, Zip Code) Length of stay at Present Address:
Home Ownership
Owned Rented Living with relatives Owned but mortgaged with ___________
Permanent Address Same as Present Home Address (Unit No/ Floor, Building Name, Building/House No., Street, Barangay, Length of stay at Present Address:
City/Municipality, Province, Zip Code) Home Ownership
Owned Rented Living with relatives Owned but mortgaged with ___________

Are you a Director, Officer, or Stockholder of PNB, or any other PNB subsidiaries Are you related to a Director, Officer, or Stockholder of PNB Savings Bank, PNB, or any other PNB subsidiaries
and/or affiliates? Yes No and/or affiliates? Yes No
If Yes, please specify company and position/affiliation____________________________________ If Yes, pls.specify name/s and relationship ________________________________________

Employer / Business Name Employer / Business Address Contact No. Email Address
EMPLOYER/BUSINESS
INFORMATION

Position/Title Basic Salary/Monthly Income Yrs. w/ Present Employer/ Status Total Yrs. Working
Business: Experience:
Regular Probationary Contractual
Nature of Business Previous Employer Years with previous employer
Banking/Financial Services Business Services Manufacturing
Transportation/Communication Wholesale/Retail/Trade Contact No. Email Address
Utilities Others __________________________
Last Name First Name Middle Name Date of Birth Mobile No./Landline No.
INFORMATION
(If Applicable)
SPOUSE

Employer/Business Name Employer/Business Address Telephone No./Extension/Local No.

Position/Title: Basic Salary/Monthly Income: Status: Total Yrs. Working

Regular Probationary Contractual Experience:
Bank Account Number Account Type Date Opened Average Balance
ACCOUNTS
DEPOSIT

Bank Card Number Member Since Expiry Date Ave. Monthly Payment Outstanding Balance Credit Limit
CREDIT
CARDS

Lending Institution Loan Amount Term Availment Date Maturity Date Monthly Amortization Outstanding Balance
LOANS
OTHER

Name Complete Address Tel. No. Mobile No. Relationship

REFERENCES
PERSONAL

Undertaking

I/We undertake to provide Philippine National Bank (the “Bank”) with the necessary documents and information in connection with this loan application. I/We hereby certify that all the documents
and information furnished to the Bank in connection with this application are correct and complete. Should any of the documents and information provided herein be found false or misleading, the
Bank may disapprove this application or, in case the loan proceeds have already been released, consider my/our loan in default and demand immediate payment thereof.

I/We fully agree and authorize the Bank, its employees, authorized representatives, related companies, and third party service providers, to: (i) obtain such documents and information as may
be required concerning this application; (ii) verify the documents and information given with third parties, including taxing authorities and government entities; (iii) to use, process and share the
documents and information obtained from the undersigned and third parties with any designated person or organization in connection with the application for the loan, the administration of the
loan granted by virtue of such application, and any transaction related to the foregoing; and (iv) to retain the information and documents collected during the application pursuant to its retention
policy or to establish, exercise or defend legal claims, for legitimate business purpose, or when provided by law. I/We hereby hold the Bank, its directors, officers, employees, authorized
representatives, parent bank, related companies and third party service providers, as well as the directors, officers, employees, of its authorized representatives, related companies, and third
party service providers, free and harmless from any liability that may arise from the use, processing, verification, gathering, transfer, disclosure or sharing, retention and disposal of the documents
and information furnished, in the absence of fraud, bad faith or gross negligence.

I/We hereby ( ) AGREE ( ) DISAGREE to authorize the Bank, its subsidiaries, affiliates, and third parties selected by the Bank, (a) to collect and use my/our information and, where permitted
by law, share it between the Bank, its subsidiaries, affiliates, and third parties selected by the Bank, to identify and inform me/us of products and services provided by the Bank, its subsidiaries,
affiliates, and third parties selected by the Bank, that may be of interest to me/us, and (b) to collect and use my/our information to promote the products and services of select third parties that
may be of interest to me/us. I/We understand that if I/we do refuse or withdraw my/our consent to (a) or (b), it will not affect my/our eligibility to avail credit.

I/we further acknowledge that the Bank shall process my personal information pursuant to its Data Privacy policy which I have accessed through PNB Website at www.pnb.com.ph

_______________________________________________________________ _______________________________________________________________
Borrower’s signature Over Printed Name of Applicant/ Date Borrower’s signature Over Printed Name of Applicant/ Date

Endorsement and Signature Verification

Referrer’s Signature over Printed Name/Date Bank Officer’s Signature over Printed Name/Date
Self-Employed / Professional Applicant: • 1 Valid ID • Latest 2 years ITR with BIR/accredited bank PL – July 2022
acknowledgement per BIR Circular 472 • Audited Financial Statements • Photocopy of Registration of Philippine National Bank is regulated by the Bangko Sentral ng Pilipinas. Form No. LD124
Business • Proof of Billing