STRICKLY PRIVATE AND CONFIDENTIAL

IMPORTANT: TO BE ACCEPTABLE AS A CO-SIGNER

MUST OWN REAL ESTATE PROPERTIES
WORTH DOUBLE THE AMOUNT OF THE
BOND REQUIRED

TO : MONARCH INSURANCE COMPANY, INC.

15/F Citibank Tower, Paseo de Roxas St., Makati City

CO-SIGNER’S INFORMATION SHEET

The undersigned hereby agree to act as CO-SIGNER on a ________________, bond

in the amount of P _________________________ applied for by
____________________________ in favor of
___________________________________________.

(ALL THE FOLLOWING QUESTIONS MUST BE FULLY ANSWERED: (IF NONE

PLEASE STATE “NONE”)
___________________________________________________________________________
__________

NAME : ____________________________________ AGE: _____ NATIONALITY:

_______________
Civil Status : ______________ if married, state name of spouse :
________________________________
Residential Address : _______________________________________ Tel. No.
____________________
Office Address : ___________________________________________ Tel. No.
____________________

1. Occupation: _________________________ Income: ________________ per annum or

per month
________________
2. Are you engaged in other business? If so, please described its nature and state the income
monthly or annually that you derive from this source:
_________________________________________________________
3. BANK ACCOUNTS-WHERE KEPT:
Current: ________________ Present Balance: _________________________
Savings:________________ Present Balance: __________________________
4. PERSONAL PROPERTY (cash, household furniture, appliances, shares of stocks, life
policies, government bonds, etc.):
Location or with (a) Amount (b) Market
Description what company Value or {c} Cash Value
a) ______________________ ____________________ ____________________
b) ______________________ ____________________ ____________________
c) ______________________ ____________________ ____________________
d) ______________________ ____________________ ____________________

Do you own car(s)/ If so, please indicate:

a) Type: _____________________ b) Model: _______________ c) Plate No.
______________
d) Estimate present market value P ___________________________________

5. REAL ESTATE OWNED:

Torrens
Description & Area Title No. Location Assessed Value Market
Value
a) _________________ __________ __________ ________________
________________
b) _________________ __________ __________ ________________
________________
c) _________________ __________ __________ ________________
________________
d) _________________ __________ __________ ________________
________________

6. If any of the aforesaid property/ies is/are presently mortgaged, please state

Name of Mortgage Amount of Loan Present Balance when Due

_________________ P _____________________ P __________________________
_________________ P _____________________ P __________________________
_________________ P _____________________ P __________________________

7. Co-Signer will please state whether applicant is related to him/her and if so in what
matter _____________________________. How long have you known the applicant
___________________________________________________
8. State whether you are or have been an endorser or co-signer for anyone and for what
amount ______________________________________________.

Reference ADDRESS Tel. No.

A) ________________________
____________________
B) ________________________
____________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
C) ________________________ ___________________________
____________________
___________________________
___________________________

The above foregoing statements and represents are true and correct to the beset of my
knowledge and belief and are made for the purpose of including the MONARCH
INSURANCE COMPANY, INC. to issue above bond.

______________________________
Signature of Co-Signer
Residence Certificate No.
________________ Issued at
____________ On ______________
TIN No.: ____________________________

PLEASE SUBMIT THIS WITH YOUR

LATEST INCOME TAX RETURN