APPLICATION FOR LOAN

(To be filled out by Applicant)

INSTRUCTION: Fill out blanks properly, write plainly, typewrite or print. If in doubt for any question or blanks,
please ask the loan clerk or any RURAL BANK OF BANSUD REPRESENTATIVE to assist you.
Application shall be accompanied by collateral papers, if any, offered as security for the loan.

APPLICANT: AGE: OCCUPATION/EMPLOYMENT:

SPOUSE: AGE: OCCUPATION/EMPLOYMENT:
NO. OF DEPENDENT/S: ELEM.: HIGH SCHOOL: COLLEGE:
RESIDENCE:
I hereby apply for a loan of Php. for a period of days repayable in
lump-sum installment at the rate of % per annum.

I. PURPOSE OF THE LOAN APPLIED FOR:

Specific Purpose Amount Date Needed

II. YEARLY INCOME AND EXPENSES:

Source of Income Amount Expenses(Itemized) Amount

III. OUTSTANDING OBLIGATIONS:

I authorize that RURAL BANK OF BANSUD (OR. MINDORO) INC., to obtain such other information as may be
required in connection with this application. I am aware that to use the proceeds of this loan for purpose
other those indicated in unlawful.
DATE: SIGNATURE:

SIGNATURE:

(bank use only)

ACTION OF LOAN APPLICATION

I.BANK MANAGER
Date:
Remarks:
Approved for
VINCENT M. SOLLER
President/Manager

II.CREDIT COMMITTEE III.BOARD OF DIRECTORS

Date: Date:
Remarks: Remarks:
Approved for: Approved for:

VINCENT M. SOLLER-Chairman PRUDENTE D. SOLLER M.D.-Chairman

VISITACION M. RICAFRENTE -Director VINCENT M. SOLLER-Director

ANACLETA G. SALES-Director MIGUEL MARCOS M. SOLLER-Director

VISITACION M. RICAFRENTE-Director

ANACLETA G. SALES-Director