BUSINESS LOAN APPLICATION FORM

☐ Cooperative ☐ Partnership ☐ Corporation

(Please mark the appropriate boxes and indicate N/ A if not applicable)

A. BUSINESS INFORMATIO N
Registered Business Name:
Principal Business Address: (Unit #, Building/House #, Street, Subdivision/Barangay/District, Municipality/City, Business address ownership: Length of stay in
Province, Zip Code) ☐ Owned (unencumbered) location:
☐ Owned (mortgaged) years
☐ Rented Number of branches:

Website/social media (Business): TIN No.

Nature of Business (Based on PSIC reference): Please specify business activity:

Business registration Date of Business Registration Expiry Date of Registration Registration Number
(Check all that apply) (mm/dd/yyyy) (mm/dd/yyyy)
☐ CDA
☐ DTI
☐ SEC
☐ BIR
☐ Barangay/Mayor’s Permit
☐ Others (Please specify):
Indicate whether the business:1 ☐ Is at least 51% (majority) owned by female/s
☐ Is at least 20% owned by female/s
☐ Has at least 1 female head (CEO, COO, President, or Vice President)
☐ Has at least 30% of females in the board of directors, if a board exists
Firm Size2 (Total assets exclusive of the land on which the business entity’s office, plant and equipment are
3
situated) ☐ Medium (Php15,000,001 to 100M)
☐ Micro (not more than Php 3M) ☐ Small (Php3,000,001 to 15M)
Annual Sales or Revenue: Number of employees: (Please indicate all paid employees and/or directly involved in business
Php operations)

Full-time: Part-time:
B. CONTACT INFORMATION
Authorized Representative 1: PhilSys Card #
(PCN):
(First Name) (Middle Name) (Last Name) (Suffix, if applicable)
Mobile Number: Landline No. (Area Code, Email Address (personal): Email Address (business): Sex: ☐ Male
Number) ☐ Female
Authorized Representative 2: PhilSys Card #
(PCN):
(First Name) (Middle Name) (Last Name) (Suffix, if applicable)
Mobile Number: Landline No. (Area Code, Email Address (personal): Email Address (business): Sex: ☐ Male
Number) ☐ Female
Top Trade References:
Name of Top Suppliers Goods Supplied/Services Contact Person Contact Number
Rendered

Name of Top Customers Goods Purchased/Services Availed Contact Person Contact Number

C. LOAN APPLICATION INFORMATION

Loan amount applied for: (subject to the approval of the bank) Php Tenor: months Frequency of payment:
Loan Facility: ☐ Credit Line Loan Purpose: ☐ Working capital ☐ Purchase of motor vehicle
☐ Term Loan ☐ Business expansion ☐ Construction/Development of real estate
☐ Others (Please specify): ☐ Acquisition of real estate ☐ Purchase of equipment/materials
☐ Loan takeout/refinancing ☐ Others (Please specify):

1
This information will solely be used to monitor information on business ownership/management in the country. Responses in this part will not affect the
assessment and approval of your loan application.
2
Subject to bank verification
3
The size of your firm will not affect the assessment and approval of your loan application.
Type of Loan: ☐ Clean Loan If secured, collateral/s and/or surety/ies offered:
☐ Secured Loan ☐ Real Estate, specify location: ☐ Deposit Hold-out ☐Php ☐USD
Name of Mortgagor: ☐ Continuing Suretyship, specify
surety:
☐ Chattel: Machineries & Equipment, Motor Vehicle Name of Co-borrower/Surety/Guarantor/Grantor:
☐ Floor Stock & Inventory
☐ Government Bonds and T-bills ☐ Others (Please specify):
D. FINANCIAL INFORMATION
Source of Funds: ☐ Revenue ☐ Savings and/or Investment
☐ Commission ☐ Others (Please specify):
Existing Business Deposit/E-Money Accounts (with the bank and other financial institutions, please indicate top 3 in terms of outstanding balance ):
Name of Financial Institution Type of Account Year Opened Type of Account Ownership
☐ Savings ☐Checking ☐E-wallet ☐Others ( Please specify) ☐ Personal ☐Business/ Merchant
☐ Savings ☐Checking ☐E-wallet ☐Others ( Please specify) ☐ Personal ☐Business/ Merchant
☐ Savings ☐Checking ☐E-wallet ☐Others ( Please specify) ☐ Personal ☐Business/ Merchant
Existing Loans ( with the bank and other financial institutions, please indicate top 3 in terms of loan amount) :
Name of Loan amount Date Granted Maturity Date Outstanding Balance Collaterals offered
Financial (mm/ yyyy) (mm/ yyyy) (if applicable, indicate if
Institution real
estate, chattel, inventory,
etc.)

Existing credit cards (with the bank and other financial institutions, please indicate top 3 in terms of credit limit) :
Name of Financial Institution Credit Limit Outstanding Balance Type of Ownership
☐ Personal ☐Business
☐ Personal ☐Business
☐ Personal ☐Business

E. UNDERTAKING/ DECL ARATION

I/We hereby confirm that all information and supporting documents provided herein are true, accurate and complete and I/we ag ree to
notify the bank of any changes in any of the information supplied. The bank can withdraw or cancel any loan approval if any information
and supporting documents are foun d to be inaccurate.
I/We authorize the bank to obtain relevant information as it may require concerning this application.
I/We hereby agree that this application shall be subject to applicable laws ( BSP circulars, rules and regulations) and policies of [ Name of
Bank].
F. DATA PRIVACY CONSENT
In compliance with the requirements of the Data Privacy Act (DPA), I/ we hereby authorize and give my/our consent to [ Name of Bank]
on the general use and sharing of information obtained in the course of any transaction/s pursuant to my banking relationship with it.
Personal information and sensitive personal information 4 may be collected, processed, stored, updated, or disclosed by the bank:
a. for legitimate bank-related purposes and requests;
b. to implement transactions which the borrower requests, allows, or authorizes;
c. to comply with the bank's internal policies and its reporting obl igations to government authorities under applicable laws; and
d. to offer and provide new or related products and services of the bank through mail, email, SMS or other means of communicatio n.
I/We confirm that I/we am/are aware that, in case of unlawful acqu isition, inaccuracy, and error, I/we have the right to access, update,
dispute, block, or correct certain personal information, or withdraw my/our consent to the use of any information provided herein, subject
to th e rights and limitations under the DPA.
I/We understand that this consent shall continue to be in effect for years or until expiration of the records retention li mits set by
applicable banking laws, whichever comes later.
I/We further warrant that, prior to submitting to the bank any informat ion (including personal information) of an individual; I/we have obtained
all necessary authorizations and consents as may be required by applicable confidentiality and data privacy laws or agreement to
enable the bank to process such information.
I/We understand that should I/we wish to access, update, dispute, block, or correct certain information, or withdraw consent to the use
of any of the information provided herein, subject to the rights and limitations under the DPA, I/we may communicate with t he [ Name
of Bank]'s Data Protection Officer at [contact details], and may lodge complaints with, and/or seek assistance from the National Privacy
Commission.
I/We have read and understood and consent to be bound by all the terms and conditions stated abov e.

Signature above Printed Name and Date

Designation of Authorized
Signatories

Third-party security providers, where applicable (e.g., sureties, mortgagors, guarantors, pledgors, assignors)
Printed Name Affiliation Contact Information
1.
2.
3.

4
Name, address, gender, age, marital status, contact details, birthday, SSS/GSIS, TIN, education, employment or financial or medical information, spouse
details, preferences, behavior, and other information classified as "personal data", "personal information", or "sensitive personal information" under
the DPA, and those of the Borrower's authorized representative/s, as well as accounts, transactions, and communications.
CHECKLIST OF REQUIREMENTS
Please provide the documentary requirements stated in the list below to facilitate evaluation of your application. This is only an
indicative list; the business may provide only those that are available and applicable.

For the bank to better consider the application, additional post-approval documents not specified in the list may be required, as
applicable.

Basic Documents Security Documents (Please check applicable item/s)

 Filled-out and signed application form  Photocopy of Transfer Certificate of Title (TCT)/
 Clear copy of one (1) valid government-issued Condominium Certificate of Title (CCT)
ID of authorized representative, if applicable  Photocopy of Tax Declaration (for land and improvement)
 Board/Partnership Resolution or Secretary's Certificate  Location/Vicinity Map
authorizing the loan and indicating the authorized  Land Transportation Office (LTO) Official Receipt
person/s to transact with the bank and sign relevant (OR)/ Certificate of Registration (CR) or Deed of
documents
Sale of Motor Vehicle
 Special Power of Attorney, if applicable
 Reservation Agreement or Contract to Sell or
Statement of Account (for Deed of Assignment (DOA)
Proof of Business Registration and Supporting Documents:
accounts only)
(Please check applicable item/s)
Cooperative
If secured by a Continuing Suretyship:
 Certificate of Registration with
 Basic Documents (as enumerated in this form) of the
Cooperative Development Authority Surety
(CDA)  Income Documents (as enumerated in this form) of the
 Certificate of Compliance, if applicable Surety
 List of elected officers
Partnership If construction loan
 Certificate of Registration with Securities  Building/Floor plan of proposed improvement
and Exchange Commission (SEC)  Bill of materials
 Articles of  Specification of proposed finishes
Partnership Corporation  Building permit
 Certificate of Registration with SEC
 General Information Sheet (GIS), if applicable If refinancing/loan take out
 Latest amended Articles of Incorporation  Statement of Account from current lender and official
and By-Laws receipts for the past 3 months
Others
Income Documents (Please check applicable item/s)  Appraisal fee
 Photocopy of Audited Financial Statements for the past
3 years with latest Income Tax Return (ITR) or Post-application requirements for real estate collateral-
Photocopy of in-house financial statements or pre- backed loans
operating balance sheets (Please check applicable item/s)
 Bank statements or photocopy of passbook for  Original owner’s copy of TCT/CCT
the past 6 months  Original Tax Clearance
 Business background/Company profile  Certified true copy of latest Tax Declaration
 Proof of other income, if any  Insurance policy/ies (for properties with improvements)
 Master Deed of Declaration (for condominium only)
 Photocopy of latest full year Real Estate Tax Receipt
(RETR)
 Price quotation of the property (for property acquisition)
 Affidavit of Consent to Mortgage Family Home

Other post-application requirements

 Certificate of Ownership for chattel
 CUSTOMER INFORMATION Annex A
SHEET FOR INDIVIDUAL
CUSTOMER
PHOTO

Customer ID No. (RM01)

Type of Code: (RM01) Personal PERSONAL

Sub-type INFORMATION
Code: (RM01) 10 – Individual 20 – Sole Proprietorship
First Name Middle Name Last Name

Present Address (RMO1) Postal Code Country Length of stay

No. Street Subdivision Barangay/District Municipality/City Province

Permanent Address (RMCA) Postal Code Country Length of stay

No. Street Subdivision Barangay/District Municipality/City Province

Business Address (for Sole Proprietorship) (RMCA) Postal Code Country

No. Street Subdivision Barangay/District Municipality/City Province

Tax Identification No. (TIN) (RMO1) Residential Phone (Area Code + Tel. No.) (RMO1) Business Phone (with local ext) (Area Code + Tel. No.) (RMO1)
- - -

Mobile Phone (RMC1) Fax No. (Area Code + Tel. No.) (RMC1) E-mail Address (RMCA)

Profession (RMC2) Source of Funds (RMC2)

10 - Salary/Honoraria 30 - Business 50 - OFW Remittance 99 – Others, pls.
specify 20 - Interest/Commission 40 - Pension 60 - Other
Remittance
Date of Birth (mm/dd/yyy) (RMC3) Place of Birth Nationality (RMC3) Gender (RMC3)
- - Municipality/City Province
Male Female
Civil Status (RMC3) Mother’s Maiden Name (First Name, Middle Name, Last Name (RMC3)
Single Married Annulled Separated Widowed
Valid ID’s Presented (ID Type & No.) (RMC3) Name of Spouse (First Name, Middle Name, Last Name (RMC3)
1.
2.
FINANCIAL INFORMATION
Employer Name (RMC4) Job Title (RMC4)

Employer Address (RMC4) Country

No. Street Subdivision Barangay/District Municipality/City Province

Occupation (RMC4) Monthly Gross Income (RMC4)

1 - Employed 3 - OFW 5 - N/A Under Php10,000 Php20,001 – 30,000 Php40,001 –
2 - Self-Employed 4 - Retired 50,000 Php10,001 – 20,000 Php30,001 –
40,000 Above Php50,000
Existing Accounts with LBP Existing Accounts with other Banks
Bank/Branch Name Type of Account
SA/ATM Trust Trade
CA/ATM Loans Credit Card
TD Treasury
FOR SOLE PROPRIETORSHIP ONLY
Business Name (RMC5/RMCN)

Date Established (mm/dd/yyyy) (RMC5) Years in Business Total Employees (RMC5) No. of Permanent Employees No. of Contractual Employees

Labor Union (Optional) (RMC5) No. of Member Employees

Nature of Work/Business/Economic Activity (Sic Code: RMC5)

0100 – Agriculture, hunting and forestry 0700 –Wholesale & retail trade 1300 –Public Administration &
Defense 0200 –Fishing 0800 –Hotels & Restaurant 1400 –Education
0300 –Mining & quarrying 0900 –Transportation 1500 –Health and Social Work
0400 –Manufacturing 1000 –Financial Intermediaries 1600 –Other Community, Social & Personal
Services 0500 –Electricity, gas and water supply 1100 –Real Estate 1700 –Private Household with Employed
Persons 0600 –Construction 1200 –Ranting and business activities 1800 –Extra-Territorial Organizations & Bodies
I attest that the above information are true, correct and voluntarily given. The bank is authorized Left Thumbmark Right Thumbmark
to give information on the account to appropriate agencies in case of questionable transactions in
relation to AMLA.

Signature of Client Date (mm/dd/yyyy)

FOR BANK USE ONLY
Account Officer: (RMC1) Borrower since: (mm/dd/yyyy) (RMC2)
Serviced by: Validated by: Encoded by:
 CUSTOMER INFORMATION Annex A
SHEET FOR INDIVIDUAL
CUSTOMER
PHOTO

Customer ID No. (RM01)

Type of Code: (RM01) Personal PERSONAL

Sub-type INFORMATION
Code: (RM01) 10 – Individual 20 – Sole Proprietorship
First Name Middle Name Last Name

Present Address (RMO1) Postal Code Country Length of stay

No. Street Subdivision Barangay/District Municipality/City Province

Permanent Address (RMCA) Postal Code Country Length of stay

No. Street Subdivision Barangay/District Municipality/City Province

Business Address (for Sole Proprietorship) (RMCA) Postal Code Country

No. Street Subdivision Barangay/District Municipality/City Province

Tax Identification No. (TIN) (RMO1) Residential Phone (Area Code + Tel. No.) (RMO1) Business Phone (with local ext) (Area Code + Tel. No.) (RMO1)
- - -

Mobile Phone (RMC1) Fax No. (Area Code + Tel. No.) (RMC1) E-mail Address (RMCA)

Profession (RMC2) Source of Funds (RMC2)

10 - Salary/Honoraria 30 - Business 50 - OFW Remittance 99 – Others, pls.
specify 20 - Interest/Commission 40 - Pension 60 - Other
Remittance
Date of Birth (mm/dd/yyy) (RMC3) Place of Birth Nationality (RMC3) Gender (RMC3)
- - Municipality/City Province
Male Female
Civil Status (RMC3) Mother’s Maiden Name (First Name, Middle Name, Last Name (RMC3)
Single Married Annulled Separated Widowed
Valid ID’s Presented (ID Type & No.) (RMC3) Name of Spouse (First Name, Middle Name, Last Name (RMC3)
1.
2.
FINANCIAL INFORMATION
Employer Name (RMC4) Job Title (RMC4)

Employer Address (RMC4) Country

No. Street Subdivision Barangay/District Municipality/City Province

Occupation (RMC4) Monthly Gross Income (RMC4)

1 - Employed 3 - OFW 5 - N/A Under Php10,000 Php20,001 – 30,000 Php40,001 –
2 - Self-Employed 4 - Retired 50,000 Php10,001 – 20,000 Php30,001 –
40,000 Above Php50,000
Existing Accounts with LBP Existing Accounts with other Banks
Bank/Branch Name Type of Account
SA/ATM Trust Trade
CA/ATM Loans Credit Card
TD Treasury
FOR SOLE PROPRIETORSHIP ONLY
Business Name (RMC5/RMCN)

Date Established (mm/dd/yyyy) (RMC5) Years in Business Total Employees (RMC5) No. of Permanent Employees No. of Contractual Employees

Labor Union (Optional) (RMC5) No. of Member Employees

Nature of Work/Business/Economic Activity (Sic Code: RMC5)

0100 – Agriculture, hunting and forestry 0700 –Wholesale & retail trade 1300 –Public Administration &
Defense 0200 –Fishing 0800 –Hotels & Restaurant 1400 –Education
0300 –Mining & quarrying 0900 –Transportation 1500 –Health and Social Work
0400 –Manufacturing 1000 –Financial Intermediaries 1600 –Other Community, Social & Personal
Services 0500 –Electricity, gas and water supply 1100 –Real Estate 1700 –Private Household with Employed
Persons 0600 –Construction 1200 –Ranting and business activities 1800 –Extra-Territorial Organizations & Bodies
I attest that the above information are true, correct and voluntarily given. The bank is authorized Left Thumbmark Right Thumbmark
to give information on the account to appropriate agencies in case of questionable transactions in
relation to AMLA.

Signature of Client Date (mm/dd/yyyy)

FOR BANK USE ONLY
Account Officer: (RMC1) Borrower since: (mm/dd/yyyy) (RMC2)
Serviced by: Validated by: Encoded by:
 AUTHORITY
To Whom It May Concern:

This is to authorize the Land Bank of the PhilippinesIlocos–Norte

Ilocos Sur
Lending
Lending Center thru its representative to request information and conduct
inquiries or verification on my/our real estate and chattel properties, court
cases, deposits, loan dealings and other transactions with any bank,
financial institution, government agency and private companies relevant
to my/our accommodation with the said Bank, thereby waiving our rights
under existing laws, rules and regulation governing secrecy and
confidentiality of deposits and loan accounts.

Issued this day of , 20 at

. Loan

Applicants:

Signature Over Printed Name Signature Over Printed

Name Complete Address:

AUTHORITY

To Whom It May Concern:

This is to authorize the Land Bank of the Philippines Ilocos– Norte

Ilocos Sur
Lending
Lending Center thru its representative to request information and conduct
inquiries or verification on my/our real estate and chattel properties, court
cases, deposits, loan dealings and other transactions with any bank,
financial institution, government agency and private companies relevant
to my/our accommodation with the said Bank, thereby waiving our rights
under existing laws, rules and regulation governing secrecy and
confidentiality of deposits and loan accounts.

Issued this day of , 20 at

. Loan

Applicants:
Signature Over Printed Name Signature Over Printed

Name Complete Address:

 CLASS D
Date:

Authorization Letter

I,/We, , with contact no.

, (Property Owner’s
Name/Firm) (Property Owner’s Contact
No.)

the of ,
located (Owner, Tenant, Manager, etc.) (Business Name if any)

in , with existing/pending loan

with, (Complete address of Business/Firm)

Ilocos Norte
ILOCOS SURLending
LENDING CENTER which account is being handled by with
Center
Contact no. do hereby authorize , of the
Land
(Name of Fieldman)

Bank of the Philippines with contact no.

and company ID No.
(Contact No. of Fieldman)

to conduct ocular inspection of the property on located

in
(Date of Inspection)

for the purpose of

appraisal. (Complete address of the property)

Signature of Owner/Tenant/Manager over Printed Name Date

Cc:
 Developer
 Condominium Administrator/Corporate Liaison Officer
 Subdivision Security Guards
 Homeowners Association/Administrator
 Caretaker