PDF Application for Loan - Dccco

[Pages:4]DCCCO Fofl* No. NA 0003

'ri

DGCCO Multipurpose Gooperative APPLTCATTON FOR LOAI!

Revised April 2017 Serial No.

Name: Membership lD Number:

Address:

TIN:

I hereby apply for a loan of

(PHP

) Payable for a period of

a month / year straight / based on the unpaid balance.

Email:

Tel/Mobile No.: Facebook:

PESOS

months to be repaid in (daily,weekly, semi-monthly, monthly, bi-monthly or quartely) installmenb of

PESOS (PHP)

"t ) plus interesl at the rate

%

Puroose:

APPLICANT'S STATEMENT!

APPLICANT

Employer: Address: TelephonelCellular Phone No.: Date Employed: Position: Monthly SalarylEstimated lncome: Other Monthly Source & lncome:Total Monthly Expenses:*n Net Disposable lncome: Number of Dependents:

Legend: n- Specify sources and income

'-Attach itemized expenses

Share Capital: P

fime Deposit P

RegularSavings: P

SPOUSE Other Savings: P

I am indebted to lhe fol6wing creditors such as doclor's bills, installments, loans (including loans with DCCC0), etc. (Aftach additional sheets, if necessary.)

Name Creditor

Address of Creditor

Amount Owed

Due,Date MonthlyAmorlization

and auinorizei 1 ) the regular submission and disclosure of my basic credit data (as defned under Republic Act No. 951 0 and its irnplementing Rules and Regulations) to the credit

agencies duly accredited by ClC. lvlembels Signature:

Date Signed:

CO.MAKERS'$TATEMENT:

GO.MAKER 1

C9jUAKEE2

Name: Name of Spouse: HomeAddress: Telephone/Cellular Phone No.: Employer: Address: Telephone No.: Monthly Salary/Estimated lncome: Other Monthly Soure,e & lncome: Total Monthly Expenses: Net Disposable Family lncome; Number of Dependents: DCCCO lD No. / Share CaPital:

I hereby certify that all the statements above are true and correct to the best of my knowledge and ability. Signature / Date Signed:

For the Board of Direetors/Gredit Gommittee/GE0/Manager/Loans 0fficer/LPs (DO NOT FILL UP)

Membership Classificalion:

Collateral/s:

Processed/Evaluated By / Date:

Verified By (Loans fficer) / Date:

AMOUNTAPPROVED:

DATEAPPROVED:

Length of Membership

E

-

months vears

Remarks:

Remarks: APPROVED BY:

Type of Loan:

IProvident nProductive

ASSIGNMEiIT OF SHARE GAPITAL AITD PEPOSIIS

t-

l, the undersigned, hereby assign my Share Capital, Tlme and/or Savings Deposits and subsequent deposits which I have or hereafter may have in DCCCO Multipurpose Gooperative" This assignment hereby authorizes the DCCCO to apply any or all Share Capital and deposits to the payment of said loan and interest, service fees, fines and all other costs and expenses when the loan becomes past due. ln case my Share Capital and depo$its are applied as payment for my delinquent loan/s, my membership will be deemed automatically termlnated and any excess amount shall be returned to me. Otherwise, DCCCO has the right to collect the deficiency.

This assignment is governed by Article 59 of Republic Act No. 9520, otherwise known as the Philippine Cooperative Code of 2008, which states 'Nonrithstanding the provision of any law to the contrary, a cooperative shall have a primary lien upon the capital, deposits and interesl of a member for any dobt due to the cooperative from such a member."

Signature Over Printed Name of Borrower With my conformity:

Signature Over Printed Name of Spouse

E8Oilils$tQ8rnolE

Loan Amount:

Date of Release:----

Date of Maturity:

Month I

For value received, l/We jointly and severally promise to pay to the DCCCO Multipurpose Coop6rative or order the sum of

(P-=*---)

with interest at the rcle ol

a

year shaighVbased on the unpaid balance, payable in

installment of

made on

and a like amount every-

thereafter

fuIllpalemdoguenttohpaasybteheenfimrsat dines.talnll-smotae/llnomt etont

be in

--% arroars/default shall make us liable to pay, in addition to the interest, a penalty of

per month.

ln case of default in payment for at least three (3) months or its equivalent, the entire loan balance is considered past d,ue. Each party to this note, whether as maker, co-mik6r, endorser or guarantor, severally waives presentment of payment demand, protest and notice of protest and dishonor of the same.

pay It is further agreed by the parties herelo that in case payment shall not be made at maturity, the debtor shall

% of the balance as service

fee, the cost of ;Iection and attorney's fees in the amouni equal to twenty per cent (20%) of the principal, interest and fines due on this note, the total of

which shall be in no case to be less than FIVE HUNDRED PESOS (P500.00).

ln case of iudicial execution of this obligation or any ather part thereof, the debtor waives all his rights under the provislons of Rule 3, Section 13 and Rule 39, Section 12 ol the Rules of Court,

Signaiure Over Printed Name of Borrower With my conformity:

Signature Over Printed Name of Spouse

Signature Over Printed Name of Co-Maker 1 Signature Over Printed Name of Co-Maker 2

REPUBLIC OF THE PHILIPPINES PROVINCE OF NEGROS ORIENTAL CITY OF DUMAGUETE

) )S.S.

ACKNOUI'LEDGMENT

BEFORE ME, this_

of.-.......-=...-- day

,2013 al Dumaguete City, Negros Oriental, Philippines, personally appeared before me:

lD Number

with- lD Numbet

and-

persons

who executed

with

the for-e-gwoinitghinst-r-u-ment

lD Number--, -and acknowledged

issued in--

to me that the same is their free, voluntary

City, known act and deed.

to me to be the same

This instrument, consisting of

) pages, including this page where this page where this acknowledgment is written, has been signed by the parties

and their instrumental witnesses on each and every page.

-(

Notary Public

Doc. No.__=-Page No._ Book No.--

Serios of

DCCCO Fo.rh No. NA 0003

DGCCO Uultlpurpose Gooperatlve APPLICATION FOR LOAN

Revised Apil 2017

Sorial No

Name

MmbolsHp lD Numbgl:_TlN,_

Address

I he.eby apply for a loan of

(PHP

) Paysble tor a period of

a monlh / ysalstraight /based on the unpaid balance.

Email

Teui\.,lobilo No.: Facebookl

PESOS

mo hs to be repald in (daily,weekly, s8mifionfrly, monhly, bi-rnonhly or qu8nU) lnst llm.nts of

PESOS (PHP)

ot ) plus intsrsst 8t the ralis

'/o

Pumose:

APPLICANT'S STATEME T:

Employer Addrss: Telophone/collular Phone No.: Date Employed: Posilion: Monhly Salary/Estimal8d lncome: Other Monlhly Soute & lncome;' Total Monhly Exponses:* Net Oisposable Income: Number of Dependents:

LBgend:'- Specify sourcos and Income

APPLICANT

" . Attach ilmizod oxpnsos

Share Capilal:P

Time Deposit P

Regular Savings: P

SPOUSE Other SavingsrP

lam indobtd lo th hllowinq crditor8 such as doclor's bills, installments, loans (including losns with DCCCo),6tc. (Attach additional shets, ifnocessary')

Name of Greditor

Address of Creditor

Arnount Owed

_D_!g-qdg MonhlvAmodization

agendos duly acctoditBd by ClC.

Member's Signature:

GO.MAKERS'STATEMETT:

qq4rxen 1

Date Signed:

sq{!a6ER 2

Name:

Name of Spouse: Home Addless:

Telephonei Cellulal Phone No.:

Emdoyer:

Addrsss: Telephone No.:

Monltrly Salary/Estimaid lncome:

oher Monlhly Souce & lncoms: Tohl lronfily ExpensEsl

Net Disposable Famity lncotne:

Number of Dependents: DCCCo lD No./ Sharc Capital:

I horeby cerflty that all the stalemeots abovs are true and corect to tho best of my knowledge and ability.

Signature / Dale Signed:

For the Board of Direstorslcredit Commlttec/cEoi Manageri Loans ffice/LPS (D0 NoT FlLt UP)

Mornbe.ship Clasrificationr

Length of MembeEhip

E

monlhs years

tl Type of Loan

Pmvidenl

Prcduclive

Collaleral/s:

Procssed/Evaluated 8Y / Date:

Verined By (Loans Ofrce0 / oale:

AMOUNTAPPROVED:

DATEAPPROVED:

Remarks Remarks:

APPROVEO BY

ASSIGNftIE T OF SHAnE CAPIIAL AND OEPOSITS

l, tho undErsEnd, horeby agslgn my Share Capital, Tlme and/or Savlngs Depo3lts end Bubssquent dsposib which I hav6 or herealtsr may havs in

DCCCO Multidrpoae

p"yr"ni oii"ii r""o

Cooperati*. ini"

hereby authorizes the DCCCO

interesl, sswioe f6e"ss,slinigensmaonndt all otheioosts and expnses when

to apply any or all Shar Capital lho loan bocomes pa6l due. ln cas

and deposits to the my Sharc Capitaland

de;osts are applled a"nsdpaymont for my dtlnquont loan/s, my membershlp wlll b deamed aulomatlcally terminatod and sny exc66s afibunt ahall bo

roturned to me. Otherwise, DCCCO has the right to collectthe deficiency-

Thls assignmont .f,fot*ittr"Gniing th"

is go,/omd p;uision of

by Article 59 of RopublicAct No. 9520, othorwise a;y hw to th contrary, a cooprative shall have a

known as tho Philippine Cooperativo primary llen upon tho capital, deposits

Cod of 2008, which states and intotest ol a member lor

any dobt du6 to he coopetivo from suoh a mombor.'

Signature Over Pdntod Name of Bo.Iowll

With rny conformity:

Signature Ov6r Printed Name ofSPouse

lEgMrSgOAY IOIE

Loan Amount:

Dale of Releasol--

Dato of Malurity:

For valuo rcelvod, l/we jointly and severalty promise to pay to th6 Dccco Multipurpose coopratlve or ord6r the sum ot

with interest at the rate oI

a

Month I ye.r stralghvbased on the unpaid balance, payable in

lnsta-l-lm%ent oI

I plodge to pay the first rnstallmont to bo

madson_-.".----

6nd alike amounl 6very-

thercai6r unUl full amount has b6en made. lnstallmont In

dl ,uk" us llable to pay, in addition to the interest, a p.|alv of

p6r month.

",rr"r"/d"Eiii

gua;i6ii"""-lii -95 ln ca6e of default ln paymnt lor at least

wtr6lh6. +r,r,t(or, co.rnarer, enoo,ger o.

three

(3)

months or it6 equivalollt, lhe ontiro loan bslanco

*"f""t i."enknent ol payment demand,

is considered past due. Eaoh party to U{8 note, prot6st and notc oI prot8t and di6honor of tho

sam6.

psy-x It iii t t"",

whirr

l! fudho. agr.od by

sha"l"l ibi"erl.ni,nror"ca"st"a,tio

tho psrtoa horrto thsl in caEo psymont shall not be mad

abneal.!ststoth.a"ny'F"IVtEe"H"UiNliDiiR"ED"r-PJES"iO"Sq(*Pr50t0"-00)'enty per cent

at rnaturlty, the debtor shall (20%) oliho principal. interest

and

fin6s

of tho balanoo Bervi@

dus on thb note. t'tBe lotal ol

ln cass ofludlclal o(cu6on of thls obligation or any othoa part therof. lh dbbr walvos all hls rlght! under the EovisiorB of Ruls 3. Soctbn 13 'nd

Rul 39, Sc{on 12 of the Rule3 of Court.

Signature Over Printod Namo of Borrower With my confo.mity:

Signature Ovor Printed Name ofSPouse

Signature Over Printed Nam ofCo-Make.1 Slgnature Ovor Printed Name of Go-Makc.2

ACKNOWLEDGMENT

REPUSTIC OF THE PHILIPPINES PROVINCE OF NEGROS ORIENTAL CITY OF OUMAGUETE

)s.s.

EEFORE ME, thisand

day

wiih

, 2013 at Dumaguoto City, Ngro6 Oriental, Philippinos. prsonlly appearod boforo m:

wltli- wilh

lD |tumbor

in-Cfty, lD Numbe

lssued

iD Number

known b ms lo b6 lho lamo

- peEons who exeouM the foregoing instrumont and ackno /ledged to me that he same is th6ir free. voluntary act and deed.

of--( This inatrumsnt, consi8ting

- - ) page3, inoluding this page whse thrs page whero this acknowldgmgnt is written, ha! been slgned bythe partles

and thoir instrumenhl wilngsses on each and svery pag6

froc. No._

Page No. Book No. Srl.e ol

-

Notary Public

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