PJH LENDING CORPORATION Unit 107 10th Flr



2” x 2” PHOTO (Co-Applicant’sForm) -159468000PJH LENDING CORPORATIONDoor 4&5, 3rd floor, Boulevard Center Bldg., Quezon Blvd., Cor. S. Artiaga St.,Davao CityGENERAL PURPOSE PERSONAL LOANLOAN APPLICATION FORM I/We, __________________________________________________ wish to apply for a loan in the sum 958851967230 NAME RELATIONSHIP CONTACT NUMBER / ADDRESS 1.)______________________________________________________ _________________________________ 2.)____________________________ __________________________ _________________________________ 3.)____________________________ __________________________ _________________________________ 00 NAME RELATIONSHIP CONTACT NUMBER / ADDRESS 1.)______________________________________________________ _________________________________ 2.)____________________________ __________________________ _________________________________ 3.)____________________________ __________________________ _________________________________ (Last Name) (First Name) (Middle Name) 71056502000250 NAME RELATIONSHIP CONTACT NUMBER / ADDRESS 4.)______________________________________________________ _________________________________ 5.)____________________________ __________________________ _________________________________ 00 NAME RELATIONSHIP CONTACT NUMBER / ADDRESS 4.)______________________________________________________ _________________________________ 5.)____________________________ __________________________ _________________________________ of PHP ________________________________________ Desired Term of Loan: __________________.Hereunder is my personal profile: 1. Home Address: __________________________________ CP. No____________________________ 2. Present Address:_________________________________________ Length of stay ______________Do you or your parents own the above properties 1. Yes[ ] No[ ] 2. Yes[ ] No[ ] Date of Birth:________________ Place of Birth:______________________________________________________ Age: ________ Sex: [ ] Male [ ] Female Civil Status in RP: [ ] Married [ ] Single [ ] Widow Citizenship: ___________________________ Email address ___________________________________ Residence Cert. No.: ____________________ Date & Place Issued: _____________________________ Current Employer: _______________________________________ Position: ______________________ Address: _____________________________________________________________________________ Telephone: __________________ Dept. / Branch ___________________ SSS No.:_________________ Length of Service: ______ Salary ___________ Other Income __________ TIN No.:________________ Bank Name: ___________________ Branch:_______________ Account No. ______________________ Father’s Name:__________________________ Mother’s Name: _________________________CP. No. ________ Parent’s Address ______________________________________________________________________ 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: _________________________CP. No. ________ Parent’s Address ______________________________________________________________________ Children & other dependents living with the family. No. of children/dependents ____________________ Name Age School/Employer/Tel. No. 3819548014105CHARACTER REFERENCES: RELATIVES 00CHARACTER REFERENCES: RELATIVES ________________________________ _________ ______________________________________ ________________________________ _________ ______________________________________ ________________________________ _________ ______________________________________ 5628456206058FRIEND / NEIGHBORFRIEND / NEIGHBORProvide details of all personal major assets, cars, property, etc..__________________________________ Existing Liabilities/ Loans: Creditors Address Balance Tel. No. ________________________ ___________________________ ______________ _____________ ________________________ ___________________________ ______________ _____________ ________________________ ___________________________ ______________ _____________ 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 bank to provide to PJH Lending any 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. _________________________________ Co-Applicant/s Signature NOTE: INCLUDE ALL MIDDLE NAMES Code: ................
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