INTECO: CREDIT APPLICATION FORM

To assist you in your credit application, please completely fill out all fields below. If uncertain with an information, you may write N/A instead.

UNIT

Year Model

Sales Executive

Date

Application No.

Unit Applied For

mu-X

TRAVIZ

DMAX

N-Series

C and E Series

F-Series

Cash Price

Downpayment

Amount Financed

Term

APPLICANT

Last Name

First Name

M I

Age

Birthdate

Education
Post-GradCollegeUnder Grad

Home Address

RentedOwn

Living w/ RelativesUsed Free

No. of Dependents

Nationality

Civil Status

Provincial Address

Tel. No.

Mobile No.

E-mail

SPOUSE / CO-MAKER INFORMATION

Last Name

First Name

M I

Age

Birthdate

Home Address

EMPLOYMENT

PRINCIPAL

EmployedSelf-EmployedOFWOthers
Name of Employer / Business
Business Address
Yrs w/ Company	Tel. No.
Position
TIN #	SSS / GSIS #

Previous Employer

Address

Res. Cert. No.

Issued at

Date

CO-MAKER

EmployedSelf-EmployedOFWOthers
Name of Employer / Business
Business Address
Yrs w/ Company	Tel. No.
Position
TIN #	SSS / GSIS #

Previous Employer

Address

Relation to Principal

NET INCOME

Applicant's Monthly Salary	P
Spouse's Monthly Salary
Other Monthly Income from


Total Monthly Income	P

Monthly Expenses	P
Rentals
Mortgage

Total Monthly Expenses
Net Monthly Income	P

CREDIT REFERENCES

Credit References

Address

Contact Nos.

SAVINGS ACCOUNT/S
Bank / Branch	Acct. No.

CURRENT ACCOUNT/S
Bank / Branch	Acct. No.

TIME DEPOSIT/S
Bank / Branch	Acct. No.