M01

OHANA CREDIT COOPERATIVE

012 Marcelino St. Santolan, Pasig City 1610 090
No. ________________
ohanacreditcooperative@gmail.com Date _______________
02-02-24

Membership Application

o I hereby apply for membership in the Ohana Credit Cooperative and agree to faithfully obey its rules and regulation, policies,
guidelines, Articles of Cooperation and By-Laws promulgated by the Board of Directors and the General assembly.
o x REGULAR (residing and/or working at Pasig City) ___ ASSOCIATE (relative of a regular member
I hereby apply for a ___
residing outside Pasig City but within NCR only) member of Ohana Credit Cooperative.
o I hereby SUBSCRIBE to Ohana Credit Cooperative the amount of
1,000
________________________________________________________ ( P _____________) and PAY the share capital
contribution not below Five Hundred Pesos (P 500) within the month. Succeeding contribution can be in a staggered basis
e.g. daily, weekly, and bi-monthly.
o I am amenable to pay the one-time membership fee of the Cooperative amounting to Two Hundred Pesos (P 200.00) only
and shall be refunded in case of rejection of this application.
o I hereby agree on my duties as a member to participate in all programs including but not limited to capital build-up and
savings mobilization of Ohana Credit Cooperative.
o It is understood that my accumulated share capital can be withdrawn only in full by giving the Cooperative the signed
withdrawal form and the release of funds will be available forty-five (45) days after the Cooperative receives the withdrawal
form.

DATA PRIVACY CONSENT

o I hereby give my consent to Ohana Credit Cooperative to receive, process, and maintain my personal information as well
any of sensitive personal information, if any, for the purpose of processing and approving of my membership application.
o I am allowing my personal information and sensitive personal information to be received, processed and maintained by
Ohana Credit Cooperative and its Board of Directors, duly authorized personnel, employees, representatives or any
accredited third party and only authorized persons/entity mentioned in this statement shall have access to my records as
well as database.
o I understand that Ohana Credit Cooperative will not share any of my personal information and sensitive personal information
with non-authorized persons or entities and will keep my information private and confidential by implementing security
standards that limit access only to authorized personnel as determine above.
o By signing this form, I give all authorized persons/ entities of Ohana Credit Cooperative my permission to use my sensitive
personal information, without any compensation to me for the purpose of processing and approving my membership form
and record-keeping.
o I have read this data privacy consent form, and fully understood every word of it and its meaning and affixed my signature
hereunder voluntarily and freely with full and complete knowledge of the meaning and intent of this document, its
implications and of my rights under existing laws.
o I am aware that by signing this document, I am waiving certain rights which I, my heirs or assignees may have against Ohana
Credit Cooperative and Others.

Signed this _________________

02-02-24 PASIG CITY
in ___________________

MICHAEL B. DOMINGO
_____________________________________
NAME OF APPLICANT WITH ABOVE SIGNATURE

Personal Information

First Name MICHAEL

Middle Name BAUTISTA

Last Name DOMINGO

Suffix (Jr, III) Nickname MIKEL

Gender M Civil Status S

Date of Birth 08-16-1987 Place of Birth QUEZON CITY

Res. Address 101 RAFAEL CRUZ COMPD,SANTOLAN PASIG CITY

OHANA CREDIT COOPERATIVE

 M01

OHANA CREDIT COOPERATIVE

012 Marcelino St. Santolan, Pasig City 1610 No. ________________
ohanacreditcooperative@gmail.com Date _______________
03-02-24

Province NCR Zip Code 1610

Res. Status OWNED LIVING WITH PARENTS No. of years of residency 37

Contact Information

Valid ID No. P9291463B PASSPORT

Encircle/check Driver’s License, PRC, Phil. Postal ID, Phil ID, UMID, SSS, Senior Citizen

Email domingomichael0816@gmail.com

Registered Cellphone 09156152165 Work Phone

TIN 250-616-780
______________________

Family Information

Spouse Name
Contact No. Member of Coop? Y___ N _____
Spouse Occupation
Mother’s Name
Contact No. N/A Member of Coop? Y___ N _____
Father’s Name
Contact No. Member of Coop? Y___ N _____
Sibling’s Name (Optional)
Contact No. Member of Coop? Y___ N _____

Employer/Business Information

Source of Income [ Business Owner ] [Contractual] [Permanent] [Self Employed]

Other(Specify) FREELANCER/SELF EMPLOYED Private ______ Government ________
Company Name MBD OUTSOURCE AND CUSTOMER ASSISTANCE SERVICE
Address SANTOLAN PASIG CITY
Contact No. 09156152165
Country of Work (if OFW)
Hire/Effectivity Date End Date, if applicable
Other Source of Income
Annual Income

Beneficiaries/ Dependents

Beneficiary 1 CATALINA B. DOMINGO Relationship MOTHER %

Beneficiary 2 BENJAMIN M. DOMINGO Relationship FATHER %
Beneficiary 3 JESLY D. NATAÑO Relationship NIECE %
Beneficiary 4 Relationship %
Beneficiary 5 Relationship %

I CERTIFY THAT THE ABOVE INFORMATION MICHAEL B. DOMINGO

_______________________________________
IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE NAME OF APPLICANT WITH ABOVE SIGNATURE

OHANA CREDIT COOPERATIVE

 M01

OHANA CREDIT COOPERATIVE

012 Marcelino St. Santolan, Pasig City 1610 No. ________________
ohanacreditcooperative@gmail.com Date _______________

WELCOME LETTER OF APPROVAL

Dear MS/MR: _____________________________

Welcome to OHANA CREDIT COOPERATIVE!

The Board of Directors of OHANA CREDIT COOPERATIVE are happy to inform you that your
membership application form submitted on ____________________ was approved during our
Special BOD Meeting last ________________.

Upon checking of the above information, you already accomplished the following:

o Attend the Pre-Membership Orientation Seminar (PMES)

o Pay the one-time membership fee amounting two hundred pesos (P200).
o Pay the initial share capital for a total of five hundred pesos (P500).

SAVE, PATRONIZE AND ENJOY THE BENEFITS OF BEING THE OHANA CREDIT COOPERATIVE
MEMBER!!

MARAMING SALAMAT SA PAGTITIWALA!

OHANA CREDIT COOPERATIVE OFFICERS

Signed by : __ _KEVIN RANCHES_______________ ____ALYSSA IZABEL EBIO______

VICE-CHAIRPERSON SECRETARY

OHANA CREDIT COOPERATIVE