AVAL MICROFINANCE

26 Torres Bugallon St., Sangandaan, Caloocan City

GENERAL PURPOSE PERSONAL LOAN

APPLICATION FORM

I/We,___________________________________________________ who to apply for a loan in the sum

(Last Name) (First Name) (M.I)
of PHP __________________________________________Desired Term of Loan: ________________.
Hereunder is my personal profile:

1. City Address: ___________________________________________________________________

Tel. No. ____________________ Length of stay: ______________
2. Home Address: __________________________________________________________________
Tel. No. ____________________ Length of stay: ______________
Do you or your parents own the above properties? 1.Yes [ ] No [ ] 2.Yes [ ] No [ ]
Date of Birth (mm/dd/yyyy): _________________ Place of Birth:
_________________________________
Age: _____________ Sex: [ ] Male [ ] Female Civil Status: ______________________
Citizenship: ________________________ Email Address:
______________________________________
Current Employer: ______________________________________ Position: _______________________
Address: _____________________________________________________________________________
Tel Number: ____________________________ Mobile Number: _______________________________
Dept/Branch: _________________________________ SSS No:
_________________________________
Length of Service: ______ Salary: __________ Other Income: ____________ TIN __________________
Bank Name: ________________________ Branch: ____________________ Account:
_______________
Father’s Name ____________________________ Mother’s Name:
_______________________________
Parent’s Address: __________________________________________________ Tel. No._____________
Name of Spouse (Asawa): ______________________________ Age:
____Occupation:_______________
Employer: ___________________________________________________ Tel. No.
__________________
Address: _____________________________________________________________________________
Position: ____________________________ Dept/Branch: _____________________________________
Length of Service: __________ Salary: ___________ Other Income: ____________________
Father’s Name: ____________________________ Mother’s Name: ______________________________
Parent’s Address: ________________________________________________ Tel. No.
_______________
Children & other dependents living with the family. No. of children/dependents:
_____________________
Name Age School/Employer/Tel.No.
1.________________________________ _________________
_________________________________
2.________________________________ _________________
_________________________________
3.________________________________ _________________
_________________________________
Provide details of all personal major assets, cars, property, etc…
__________________________________
Existing Liabilities / Loans:
 AVAL MICROFINANCE
26 Torres Bugallon St., Sangandaan, Caloocan City

Creditors Address Balance Tel. No.

1.__________________ ____________________________________ _______________ _____________
2.__________________ ____________________________________ _______________ _____________
3.__________________ ____________________________________ _______________ _____________
Under pain of perjury I hereby confirm that all information provided on this form and attached hereto are
true and correct. I hereby authorize my company to provide to AVAL microfinance ay account
information they may require. I understand that my application may be denied for any reason whatsoever
which the company has no obligation to disclose.

_____________________________
Signature overprinted name/Date