LOAN APPLICATION FORM

Business Address: 189 M. L. Quezon Street,

Date Applied: ___________________ Personal Loan Purok 3 New Lower Bicutan, Taguig City 1632

New Request Renewal Business Loan Email: rpr@jrsl.ph

Business # (02)-904-1985, 0917-579-7164

Required Documents Client Requirement

Before you proceed, please take note of the following requirements: Before you proceed, please take note of the following requirements:
1. Application Form 1. You are at least 21 years of age.
2. Two (2) V alid ID's (Passport, Drivers License, PRC ID, etc.) 2. You are at least 1 year resident at current address
3. Three (3) Months Payslip and COE 3. You are a regular employee by your current employer.
4. Recent Proof of Billing 4. You are at least 3 years in business (Business/Self-Employed).
5. Information Sheet

Do not Leave any blank fields, state N/A if the field is not applicable to you.

Loan Details:

Amount Requested: ______________________ Loan Payment Dates:

Purpose of the loan: ______________________ 5th & 20th 15th & 30th
Months to Pay off Loan: _____________ Months Best day and time to call:
Referred By: _____________________________ ______________________________________

About You:

Full Name: (First Name, Middle Name, Last Name) Valid ID's Submitted:

_____________________ _____________________ _____________________ 1. ID Type: ___________ ID # ___________________

Date of birth (mm/dd/yy): Gender: Male Female 2. ID Type: ___________ ID # ___________________

Title: Mr Ms Mrs Civil Status: Married Single Single Parent Current Home Address:
______________________________________
Place of birth (Please indicate City or Municipality of birth):
______________________________________
________________________________________
Number of dependents: ________ _____________________Zip Code
How long have you been at this address? ________
Home phone: -
Mobile phone: - Permanent Home Address:
Email: _____________________________________________ ______________________________________

Home ownership: Owned Owned Mortgaged ______________________________________

Rented Rented/Living with parents/relatives _____________________Zip Code

Owned/Living with parents/relatives How long have you been at this address? ________

Complete Mother's Maiden Name: _____________________________________________

Total Liabilities/Expenses:

HOME MONTHLY EXPENSES AMOUNT LOANS PAYABLES AMOUNT

Rent Php _____________ Car Loan Php _____________
Electricity Php _____________ Home Loan Php _____________
Water Php _____________ Other Loan Php _____________
Internet Service Php _____________ Total Php _____________
Cable TV Service Php _____________
Phone Service Php _____________
Insurance Php _____________
Tuition Fee Php _____________
Total Php _____________

Character References:

Family member / Relative Colleague / Supervisor / Friend

Name: ______________________________________________ Name: ______________________________________________
Address: ______________________________________________ Address: ______________________________________________
Contact Number: ________________________________________ Contact Number: ________________________________________
Relationship: ____________________________________________ Position: _______________________________________________
 Employment and Income:

Employment Sector: Private Public Self-employed Business Business Address:

_________________________________________
No. of years with present employer: ____________
_________________________________________
Date Started: ____________________
_____________________ Zip Code
Years in business (if self-employed/Business): ____________
Employer/Business name: ________________________________________ Office Contact Number:
__________________________________________________
Position/Job Title: _______________________________________________
Monthly Salary/Income:
Nature of business/industry: _______________________________________
__________________________________________________
Total no. of years working: ____________

Source/s of funds: Business income Inheritance Spouse/Parental/ Salary Rental Income

Partner Support
Self Employment Investment Loan Trust Fund
Personal Savings Pension Sale of property Grants/Scholarship

*Please update us of changes to your registered email address and contact Number to ensure you receive updates from us. To update your
email address and contact number, you may call or text +63917-579-7164 or email at jrswiftlending@gmail.com

Bank details: (Please use Bank of the Philippine Islands for now.)

Should your request be approved. Where do you want the funds to be transferred?

Bank Name: ______________________________________________________

Account Number: __________________________________________________
Name/s on the Account: _____________________________________________

Formal Declaration

I hereby certify that all information herein provided are true and correct to the best of my own personal knowledge. I hereby freely and
and voluntarily give consent and authorize John Richard Swift Lending Inc. to obtain information as it may require concerning my loan
application. Any information given by me or other person duly authorized by me which is NOT TRUE nor ACCURATE, will automatically
cause John Richard Swift Lending, Inc. to reject my application

By providing or submitting my personal data, I agree and give consent to John Richard Swift Lending, Inc. and if necessary, its product/service
providers and partners to collect, store, use, and process my personal data for the purposes of my inquiry, application, or transaction with
John Richard Swift Lending Inc. By signing this application form, I hereby agree in giving authority to the representative of John Richard Swift
Lending, Inc. to inquire and submit my credit information from TransUnion and other credit bureau relevant to this application.

_____________________________________________ _______________________________
Signature of Applicant Over Printed Name Date