Application Form

SEAMAN AND OFW LOAN

Alonzo Roxas Rivera

Loan Specialist: _______________________________ 09053449573
Contact no: _______________________ Purpose of Loan: ______________________________

Borrower’s Information
Name : Angelie narvasa hadama Gender : Female Age: 37 Birthdate : 1985/09/29
Present Address :Utsunomiyashi Imaizumi Shinmachi 45-7 Imaizumi Shinmachi Tokai haist 1-103 Civil Status : Divorce

Provincial Address : Purok 4 nangka consolacion Cebu city Religion : Roman Catholic
Permanent Address : Tochigi ken japan
Education : High school Graduate High school Level College Level College Graduate
Year Graduated : School Last Attended : FB Account Name :
2000/2004 Jellian chua hamada
Course : Bachelor law Email Add : Mobile Number : 080-7881-7239
Spouse Name : Birthdate: Age: Contact no:
Provincial Address : FB Account Name:

No. of Dependents: ___________

Name of Children Age /Civil School OR Employer/Business Residence Address Net Income
(full name) Status Allowance
Kheanna narvasa hamada 13y single Shogako high school Japan Allowance
Kenjie narvasa hamada 11y single Minami shokachi elementary school Japan Allowance
Ariana narvasa 5y single Takebayashi nursery school Japan

House Ownership:
_______
Miss Hamada
Owned _______ Mortgaged _______ Used Free _______ Renting ________Others:
50,000
Amount of Rent/Amortization _________________ 5years
Length of Stay: _______________ Nearest Landmark: ________________________________________
Hamada angelie narvasa
Electric or Water Bill Registered Name: ________________________________________________ Self
Relation:______________________________
Assets:
Vehicle Model – Plate No. Mo. Amortization Kind / size of Property Location

Co –borrower’s Information
Name : Jessie renario valle Gender : Male Birthdate : 1990/12/22 Age : 33
Address: Purok 4 cansaga consolacion Cebu city
Relation to borrower : Fiancé FB account : Valle jessie Civil Status : Single
Education : High school Graduate High school Level College Level College Graduate

Year Graduated :2022 School Last Attended : Tesda learning center lilo-an Cebu Course : Welding
Home phone no : Mobile No: 09924367523 Email Address : vchad2594@gmail.com

Character Reference (at least 2 relative and 2 friend)

Name Address Contact Number Relation
1 Elizabeth arcilla narvasa Sitio,laray maglasang consolacion Cebu Facebook only Mother

2 Donny arcilla narvasa Sitio,laray maglasang consolacion Facebook only Brother

3 Jolly Abe Saitama japan Friend

We dont give personal information
4 Roselle Fuentes Friend
Chiba japan We’re not give personal information

Manning / Crewing Agency

Name of Agency
Office Contact No. (LandLine)
Crewing Manager / Informant

UNDERTAKING
I/We, hereby certify that all the information furnished in this Application Form are true, correct and complete, and that the signatures herein are trueand genuine. I/We hereby authorize
Global SME Loans, Inc. to obtain such information may be required concerning the validity and veracity of information provided, using any applicable methods or processes, including my/our loan and
deposit accounts, and waive my/our rights under R.A. 1405. I/We further agree that this application and all supporting documents and any other information obtained by Global SME Loans, Inc. relative to
this application shall remain as Global SME Loans, Inc. property whether or not the loan is granted. I/We agree that Global SME Loans, Inc. has no obligation to furnish me/us the reason of such rejection.
I/We also understand that any false statement or concealment of information which may be discovered after the loan has been granted shall be sufficient basis for Global SME Loans, Inc to consider the
loan due and demandable immediately.

___________________________________
Angelie narvasa Hamada ______________________________________
Jessie ranario valle
Borrower’s Signature over printed name Co -Borrower’s Signature over printed name

PRIVACY NOTICE AND CONSENT FORM

The privacy and security of your personal data (“Personal Information”) which we collect from you is important to us. It is equally important that you understand how we handle this data. In
conducting our business, we must collect “Personal Information” from you. It will be strictly used to administer your account and to provide the products and services you have requested from us and
to further meet your needs and the standard procedures of our business. We will treat your “Personal Information” confidential. It will only be disclosed, subject to our permission, to our affiliates
and partners such as credit bureaus, collection companies, and other financial institutions for the purpose of assisting you in your financial needs, and for the effective handling of your account. For
the proper assessment of your loan application, you hereby allow GLOBAL SME LOANS, INC. (GSLI) directly or through its partners, to collect, retrieve, process, use, and store your “Personal
Information” such as name, age, photographs, fingerprints, mobile number/s, mobile phone usage data, employment details, income, financial data, financial profile, credit standing, loan payment
history, other means of positive identification such as voice, photograph, fingerprint, signature, iris and/or such other identifiable features, and other information required in the application form for
the purpose of reviewing and processing your loan application. Further, you hereby give consent to the collection of personal data from yourself, and/or from telecommunications companies, banks,
credit bureaus, payment platforms, airlines, utility companies, suppliers, and employers for credit evaluation purposes. Furthermore, in case of restructuring your loan obligation, you are giving
consent and allowing GSLI to disclose and collect information from the above-mentioned institutions and people. Throughout the processing of the your “Personal Information”, your rights under the
Data Privacy Act of 2012, such as the (1) right to be informed, (2) right to object, (3) right to access, (4) right to rectification, (5) right to erasure or blocking, and (6) right to damages, shall be upheld.

For your complete rights as a data subject, please visit https://www.privacy.gov.ph/data-privacy-act/

For further information regarding the privacy policy, you may visit our website at https://globalsme.ph/

Angelie narvasa hamada

___________________________________ Jessie renario valle
______________________________________
Borrower’s Signature over printed name Co -Borrower’s Signature over printed name