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WALK-IN REFERRAL INTERNET


Branch OTHERS (Please Specify)

2x2
Last Name First Name Middle Name Birthday Age Sex : PHOTO
(mm/dd/yy) Male
Female
Marital Status : Mother’s Maiden Name
Single Married Separated Widowed

Parent’s Name Age ; Age


Educational Attainment : High School College Post-Graduate Others
Name of Dependents Age School

Present Address (House No. / Street / Village / Subdivision / Barangay / Municipality / City / Province)

Residence Ownership : Home Phone Number Cellphone Number/s


Owned Mortgaged Rented With Relatives
Previous Address Length of Stay
E-mail Address
Provincial Address Length of Stay

Do you own a motor vehicle? No Yes; How many? Make Model Plate No.

Employment : Self-Employed Private Government Professional Employer / Business Name DTI / Sec. Reg. No.
Other Income
Employer / Business Address (Unit / Floor / Building / Street / Village / Barangay / Municipality / City / Province) Length of Stay /
Years in Business

Employer / Business Tel. No. Position Monthly Income Professional License No. SSS No. TIN Contractual
Status :
Permanent

Last Name First Name Middle Name Birthday Age Sex : Male Female
(mm/dd/yy)
Educational Attainment : High School College Post-Graduate Others
Employment : Self-Employed Government Employer / Business Name DTI / SEC. Reg. No. Employer / Business Tel. No.
Private Professional
Employer / Business Address (Unit / Floor / Building / Street / Village / Barangay / Municipality / City / Province) Length of Stay /
Years in Business
Position Monthly Income Professional License No. SSS No. TIN Status : Contractual Permanent

Name of Employer / Nature of Business Name of Business


Relatives References (Parents, Brothers, Sisters not living with the Borrower)
Address of Employer / Business
NAME ADDRESS CONTACT NUMBER/S Owned Rented / Mo P.________
Length of Stay / Years in Business Tel. No. Monthly Income

BANK / BRANCH ACCOUNT TYPE ACCOUNT NO. DATE OPENED

DATE: ___________________________________ I/We hereby certify that all the information furnished in this Application Form are true, correct
DEAR: ___________________________________ and complete, and that the signatures appearing herein are true and genuine. I/We hereby
authorize SOUTH ASIALINK FINANCE CORPORATION to obtain such information as maybe
required concerning the validity and veracity of the information provided in this application
This is to authorize SOUTH ASIALINK FINANCE CORPORATION or its using any applicable methods of processes, including my/our loan and deposit account, and
authorized representative to verify my/our savings/checking waive my/our rights under R.A. 1405. I/We further agree that this application and all supporting
account with your bank. documents and any other information obtained by SOUTH ASIALINK FINANCE CORPORATION
relative to this application shall remain as ASIALINK’s property whether or not the loan is
You are allowed to disclose the date of opening of my/our granted. I/We agree that SOUTH ASIALINK FINANCE CORPORATION has no obligation to
savings/checking account, the handling and the Average Daily furnish me/us the reason for such rejection. I/We also understand that any false statement or
Balance (ADB) for the last six months. concealment of information which maybe discovered after the loan has been granted shall be
sufficient basis for SOUTH ASIALINK FINANCE CORPORATION to consider the loan due and
Bank Branch/Address Account Type Account No. demandable immediately. I/We hereby undertake that the proceeds of the loan application if
approved shall not be used for placement purposes and/or to pay any chargeable and allowable
fees in relation to my travel and/or work abroad. Otherwise, SOUTH ASIALINK FINANCE
CORPORATION has the right to disapprove the loan, or if granted to rescind the contract of loan
and shall declare all unpaid amortization immediately due and demandable together with all
interest and damages.

Thank you very much for your kind assistance.


Very Truly Yours, PRINCIPAL BORROWER SPOUSE
(Printed Name and Signature) (Printed Name and Signature)

CO-BORROWER DATE
(Signature Over Printed Name) (Printed Name and Signature)