Credit Requirements:

2x2 ID Picture (Buyer and Co-maker) Proof of Billing

Proof of Income Residence Certificate/ Cedula
CREDIT APPLICATION FORM
First Name: Middle Name: Last Name: Date:

Sex: Age: Citizenship: Birth Date: Religion:

 Male  Female
Civil Status: TIN No: Res Cert No. Date Issued Place Issued
 Single  Married  Divorced/Separated  Widowed
Present Address: Length of Stay

HOUSE  Owned  Rented  Mortgaged  Provided By ________________________

LOT  Owned  Rented  Mortgaged  Provided By ________________________
OTHER PROPERTIES  TV  Ref  Stereo/ Component Gas Range Motorcycle  Computers
 Farm/Lot Address__________________________________ Size______________________
Provincial Address:

Home Phone Number Office Phone Number Mobile Phone Number Email Address:

Name of Spouse (First/Middle/Last) Age Number of Dependents

Provincial Address of Spouse: Mobile No. Email Address

Name of Dependents AGE Grade / Occupation Position School/Company Employed

1. 1. 1. 1.
2. 2. 2. 2.
3. 3. 3. 3.
4. 4. 4. 4.
Name of Father Name of Mother

Address Tel No / Mobile No

Source of Income
 Self-Employed/Business  Employed Allotment  Provided by ____________________________________
CREDIT REFERENCES(Preferably Installment Purchases/Cash Loan)
STORE/BANK ITEM/ LOAN AMOUNT TERM DATE BALANCE
___________________________ ____________________ ________ ___________ ______________
___________________________ ____________________ ________ ___________ ______________
___________________________ ____________________ ________ ___________ ______________
___________________________ ____________________ ________ ___________ ______________
PERSONAL REFERENCES
NAME RELATIONSHIP TEL NO ADDRESS
_______________________ ______________ _____________ _______________________________________
_______________________ ______________ _____________ _______________________________________
_______________________ ______________ _____________ _______________________________________
Name of Employer Position

Address Tel No

Date Employed Salary (Net)

Spouse Employer Position

Address Tel No

Date Employed Salary (Net)

UNIT TO BE USED FOR  Personal Use  Business Use  Gift  Used by Relative / Friend
MODE OF PAYMENT  Post Dated Checks  Cash Paid to Office  Cash for Collection  Credit Card
Co-Maker Information
Name: Age: Sex:  Male  Female
Home Address: Tel No:

Residence:  Owned  Rented  Mortgaged  Provided by ________________

Civil Status: Relationship w/ Applicant
 Single  Married  Divorced/Separated  Widowed
Birthday (mm/dd/yyyy) TIN Mobile No

Present Employer Date Hired Position Tel No

Employer’s Address Employment Status

 Contractual  Probationary  Regular
Credit References (Installment/Banking Institutions)
1. ___________________________ 2. ____________________________ 3. _____________________________
Sketch of Residence and/or Business Address: (Applicant)

Sketch of Residence: (Co-Maker)

This is to authorize Premio and its representatives to perform credit inquiries and verify data written above.

______________________ ________________________ __________________________

Co-buyer’s Signature Spouse’s Signature Applicant’s Signature

All Fields Below are to be filled up by Premio Representatives only:

Brand Model Color

LCP Downpayment Del Charge Total (Initial Payment) OR No./ Date

Terms Gross Balance after Down Due Date PPD

RECOMMENDATION
Monthly Amort.  APPROVED APPROVED W/ CONDITION DISAPPROVED
1 ____________ REMARKS:
3 ____________
6 ____________ _______________________________________________________________________________
12 ____________ _______________________________________________________________________________
18 ____________ _______________________________________________________________________________
24 ____________
30 ____________
36 ____________ _______________________ _____________________ _____________________
_____ ____________ Credit Investigator Supervisor Manager/OIC