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    Loan Application and Signature Card

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    arielabarico0

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    © All Rights Reserved
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    Loan Application and Signature Card

    Uploaded by

    arielabarico0
    2 views3 pages

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    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
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    Download as pdf or txt
    2 views3 pages

    Loan Application and Signature Card

    Uploaded by

    arielabarico0

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    Date/Time Signed: 01-Jul-2022 10:08:58 AM | Verification Code: 550035

    LOAN APPLICATION FORM


    Odette Enterprise Rehabilitation Financing (ERF) Program (For Non-Tourism New Borrowers)

    BORROWER’S INFORMATION
    Last Name: ABARICO First Name: ARIEL Middle Name: VILLAMOR

    Suffix: Date of Birth: 01/28/1980 Sex: Male Female


    Mobile No.: (0951) 3666782 Landline No. E-mail Address: [email protected]

    IDENTIFICATION DOCUMENT
    Government-issued ID: DRIVER'S LICENSE I.D. No.: H05-03-012824

    RESIDENTIAL ADDRESS
    0125 PUROK HOLY INNOCENT ICHON
    House/Lot No., Street Name, Subdivision Barangay
    MACROHON SOUTHERN LEYTE Region VIII (EASTERN VISAYAS)
    City/Municipality Province Region

    BUSINESS INFORMATION
    Business Name: ARIEL SARI SARI STORE

    Business Address: Same as residential address of the borrower Not same as residential address of the borrower
    (Supply this only if different from residential address provided above)
    0125 PUROK HOLY INNOCENTS ICHON
    House/Lot No., Street Name, Subdivision Barangay
    MACROHON Region VIII (EASTERN VISAYAS)
    City/Municipality Province Region

    Estimated Asset Size: 0 Estimated Value of Damaged Assets: 75,000


    (Excluding land)

    REQUESTED LOAN TERMS


    Loan Amount: PhP 37,500 Loan Tenor: 36

    Grace Period: 6

    LOAN RELEASE DETAILS


    G-XCHANGE, INC. (GXI) ARIEL ABARICO 09513666782
    Bank/EMI Name Account Name Account No.
    CHECKLIST OF REQUIREMENTS
    One (1) government-issued ID (with signature) of the loan A selfie of the loan applicant holding the government-issued ID
    applicant clearly capturing both the loan applicant’s face and government ID

    For corporations: Latest General Information Sheet For partnerships: Articles of Partnership

    Proof of bank account or e-money account

    For loans not more than PhP50.0 thousand: 2021 Barangay Permit; or

    For loans more than PhP50.0 thousand: 2021 Mayor’s Permit; or

    Department of Trade and Industry (DTI) or Local Government Unit (LGU) Certification (in case of lost documents).
    Date/Time Signed: 01-Jul-2022 10:08:58 AM | Verification Code: 550035

    UNDERTAKING/ DECLARATION
    I/We hereby confirm that all information and supporting documents provided herein are true, accurate and complete and I/we
    agree to notify the Small Business Corporation (SBCorp) of any changes in any of the information supplied. I/We further
    authorize SBCorp to verify and validate all information and supporting documents that I/We submitted to SBCorp before all the
    concerned government agencies (DTI, BIR, SEC, and LGUs). In the event that, SBCorp upon verification with the concerned
    government agencies discovers that any and/or all information or supporting documents submitted is/are
    inaccurate/false/fraudulent, I/We acknowledge that SBCorp can withdraw or cancel any loan approval issued in my/our favor.

    I/We authorize SBCorp 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 SBCorp.
    DATA PRIVACY CONSENT
    In compliance with the requirements of the Data Privacy Act (DPA), I/we hereby authorize and give my/our consent to Small
    Business Corporation (SBCorp) on the general use and sharing of information obtained in the course of my/our transaction. Any
    disclosed information, including personal and sensitive information may be collected, processed, stored, updated, or disclosed
    by SBCorp on the following purpose:
    a. For legitimate purposes and requests;
    b. To implement transactions which the borrower requests, allows, or authorizes; and;
    c. To provide new and related products and services of SBCorp; and
    d. To comply with the SBCorp’s internal policies and its reporting obligations to the government authorities under
    applicable news.
    I/ we certify that all provided information is correct and true to my /our knowledge. Any false information and
    misrepresentation made in this document shall cause the filing of administrative/criminal case/s against me/us. I/We authorize
    SBCorp to verify/validate the information and supporting documents I/We submitted to SBCorp before the concerned
    government agencies (DTI, BIR, SEC, and LGUs). Moreover, I/we confirm and recognize that SBCorp or their credit delivery
    partners and service providers may disclose collected information or any basic credit data including related changes or
    correction on the data in Credit Information Corporation (CIC) and other authorized entities as stated in the Credit Information
    Act of 2002 (R.A. 9510).

    ARIEL VILLAMOR ABARICO 01-Jul-2022

    Signature under Printed Name (Borrower) Date

    Signature under Printed Name (Co-borrower) Date


    Date/Time Signed: 01-Jul-2022 10:08:58 AM | Verification Code: 550035

    SMALL BUSINESS CORPORATION


    BORROWER'S SIGNATURE CARD
    Borrower : ARIEL VILLAMOR ABARICO
    Address : 0125, PUROK HOLY INNOCENT, ICHON, MACROHON, SOUTHERN LEYTE
    Contact Person :
    Telephone No/s. : Fax No/s. :

    AUTHORIZED SIGNATORIES


    1 
    2 
    3

    Name Name Name

    Position Position Position

    TIN TIN TIN

    SPECIMEN SIGNATURES

    a. a. a.

    b. b. b.

    c. c. c.

    SB Corp - QP - 01 - RL - F50 Verified by:

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