PNB New York Branch's Consumer Loan

Checklist for Consumer Loan Application

Duly accomplished loan application form by applicant (and co-applicant, if applicable). All blanks must be completely filled in. If a section or particular question does not apply, write "NA".
Most recent pay stub of applicant (and co-applicant, if applicable.)
Most recent copy of Income Tax Return (1040..) for applicant (and co-applicant, if applicable).
Proof of employment (starting date and gross annual salary) for applicant (and co-applicant, if applicable).
2 forms of picture ID (e.g. passport, driver's license, picture credit card, etc.) to be presented at loan release.
$20.00 non-refundable processing fee payable by cash (do not send cash through the mails)/certified check/money order upon submission of your application.
Deliver or mail all documents to: Philippine National Bank, New York Branch, 546 Fifth Avenue, 8th Floor, New York, NY 10036 Attn: Loans Processing Unit.

Consumer Loan Application Form

Amount Requested: $_____________________

Term Requested: _______________________

Proceeds of loan to be used for: _______________________________________________________________________

Section A - Information regarding Applicant

Full Name (Last, First, Middle): _______________________________________________________________________

Birthdate: _______/________/___________

Present Street Address: __________________________________________________________ Years There: _______

City: ____________________________________ State: _________ Zip Code: ____________ Telephone: _________

Previous Street Address: _________________________________________________________ Years There: _______

City: ____________________________________ State: _________ Zip Code: ____________

Social Security No: ______________________ Driver's License No: __________________

Present Employer: ________________________________________________________________ Years There: _______

Position or Title: _______________________ Supervisor's Name: __________________________________________

Employer's Address: ____________________________________________________ Telephone: _________

Previous Employer: _______________________________________________________________ Years There: _______

Previous Employer's Address: _____________________________________________________ Telephone: _________

Present Gross Annual Salary: $_____________________________ No of Dependents: ____ Ages: ______________

Other Income: $_______________ per _________________. Source(s) of other income: _______________________

Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation. If you do wish it to be considered, please check one of the following: Alimony, child support, separate maintenance received under [__] court order, [__] written agreement, [__] oral understanding.

Is any income listed in this section likely to be reduced before the credit requested is paid off? [__] No. [__] Yes. Explain in detail on separate sheet.

Have you ever received credit from us? [__] No. [__] Yes. If yes, when?______________________________

Checking Account No ________________________________ Institution and Branch ____________________________

Savings Account No ________________________________ Institution and Branch ____________________________

Name of Nearest Relative not living with you: ____________________________________ Telephone: _________

Relationship: ________________ Address: ________________________________________________________

Section B - Information Regarding Joint Applicant

Full Name (Last, First, Middle): _______________________________________________________________________

Birthdate: _______/________/___________

Present Street Address: __________________________________________________________ Years There: _______

City: ____________________________________ State: _________ Zip Code: ____________ Telephone: _________

Previous Street Address: _________________________________________________________ Years There: _______

City: ____________________________________ State: _________ Zip Code: ____________

Social Security No: ______________________ Driver's License No: __________________

Present Employer: ________________________________________________________________ Years There: _______

Position or Title: _______________________ Supervisor's Name: __________________________________________

Employer's Address: ______________________________________________________ Telephone: _________

Previous Employer: _______________________________________________________________ Years There: _______

Previous Employer's Address: _____________________________________________________ Telephone: _________

Present Gross Annual Salary: $_____________________________ No of Dependents: ____ Ages: ______________

Other Income: $_______________ per _________________. Source(s) of other income: _______________________

Is any income listed in this section likely to be reduced before the credit requested is paid off? [__] No. [__] Yes. Explain in detail on separate sheet.

Have you ever received credit from us? [__] No. [__] Yes. If yes, when?______________________________

Section C - Marital Status

Note: Do not complete if this is an application for individual unsecured credit.

Applicant : [__] Married [__] Separated [__] Unmarried (including single, divorced and widowed)

Other Party: [__] Married [__] Separated [__] Unmarried (including single, divorced and widowed)

Section D - Asset and Debt Information

Note: If section B was completed, this section should be completed giving information about both the Applicant and Joint Applicant. Please mark Applicant related information with an "A".

Assets Owned
Use separate sheets if necessary.

-------------Description of Assets------------- ----US$ Value---- --Subject to Debt?-- ----Name(s) of Owner(s)----

Cash

Automobile (make, model, year)

Cash Value of Life Insurance (Issuer, Face Value)

Real Estate (Location, Date Acquired)

Marketable Securities (Issuer, Type, No of Shares)

Others (List and brief description)

TOTAL ASSETS - US$_____________________________

Outstanding Debts
Include charge accounts, installment contracts, credit cards, rent, mortgage, etc.)

------Creditor------ -Debt Type- --Account-- --Orig Amt-- --Present Balance-- --Monthly Payments-- -Past Due?(Y/N)-

TOTAL DEBTS - US$____________________________

Credit References

-----------Credit References------------- ---------US$ Amount--------- -----Date Paid-----

Are you a co-maker, endorser or guarantor on any loan or contract? [__] Yes. [__] No.

If yes, for whom? _____________________________________ to whom? _______________________________________

Are there any unsatisfied judgements against you? [__] Yes. [__] No.

If yes, to whom owed? _________________________________ for how much? US$_______________________________

Have you ever been declared bankrupt in the last 14 years? [__] Yes. [__] No.

If yes, where? __________________________________ what year? ___________________________

Have you ever rendered service for any arm of the US Military Forces? [__] Yes. [__] No.

If yes, where? __________________________________ When? ________________________________

Other obligations (e.g. liability to pay alimony, child support, separate maintenance. Use separate sheet if necessary).

Section E - Secured Credit

Briefly describe the property to be given as security.

____________________________________________________________________________________________________

____________________________________________________________________________________________________

List names and addresses of all co-owners of the property:

-------------------- Name ---------------------- ------------------------- Address ----------------------

If the security is real estate, give the full name of your spouse (if applicable): ______________________

Everything that I have stated in this application is correct to the best of my knowledge. I understand that you will retain this application whether or not it is approved. You are authorized to check my credit and employment history and to answer questions about ykour credit experiences with me. I understand PNB normally obtains credit reports for all loan applications and any updates, renewals or extensions of credit granted. Upon request, PNB will inform me if a credit report has been obtained and will give me the name and address. Upon request, PNB will inform me if a credit report has been obtained and will give me the name and address of the agency furnishing the report.

Applicant's Signature: __________________________________________ Date: _______________________________

Other Signature (if applicable): ________________________________ Date: _______________________________

This page accessed

times since the 15th of January 1997.
Page created by: pereyes@pnbnewyork.com
Changes last made on: Thu Jul 11 07:19:36 1996