CITIMOTORS, INC.

CREDIT APPLICATION
Note: All information will be treated
Pasong Tamo cor., Don Bosco St. Makati City
strictly confidential.
PLEASE PRINT LEGIBLY

IMPORTANT: TO FACILITATE PROCESSING OF THIS APPLICATION PLEASE FILL UP THIS FORM COMPLETELY
LAST NAME FIRST NAME MIDDLE NAME DATE OF BIRTH BIRTHPLACE CIVIL STATUS CITIZENSHIP

NAME OF SPOUSE DATE OF BIRTH BIRTHPLACE NO. OF DEPENDENTS AGES

PRESENT ADDRESS LENGTH OF STAY

[ ] OWNED [ ] PROVIDED

[ ] MORTGAGED [ ] AMORTIZED

YRS MOS [ ] RENTED [ ] LIVING W/ PAREN

IF LIVING AT ABOVE ADDRESS FOR LESS THAN 2 YEARS GIVE PREVIOUS HOME ADDRESS LENGTH OF STAY

YRS MOS
PRESENT MONTHLY RENTAL NAME OF LANDLORD ADDRESS OF LANDLORD TELEPHONE

PRESENT EMPLOYER POSITION/DEPARTMENT LENGTH OF SERVICE MONTHLY INCMOE TELEPHONE

PREVIOUS EMPLOYER ADDRESS NATURE OF BUSINESS MONTHLY INCMOE TELEPHONE

BUSINESS ADDRESS TELEPHONE

SPOUSE'S OCCUPATION/EMPLOYER ADDRESS POSITION MONTHLY INCME TELEPHONE

NAME OF NEAREST RELATIVE NOT LIVING WITH YOU ADDRESS RELATIONSHIP TELEPHONE

NAME OFSPOUSES RELATIVE NOT LIVING WITH YOU ADDRESS RELATIONSHIP TELEPHONE

MONTHLY EARNINGS AND EXPENSES BANK ACCOUNT ACCOUNT NO. DATE OPENED PRESENT BANK

SALARY
EXPENSES

ITEM APPLIED FOR PAYABLE IN : MONTHS

CASH PRICE DOWN PAYMENT AMOUNT TO BE FINANCED

PLACE OF USE PURPOSE OF USE

RES. CERT NO. DATE PLACE TIN SSS/GSIS NO N/A

ACR NO. DATE PLACE Verification of Date

I hereby certify that all data and statements in this application are
correct and complete, and are made for the purpose of obtaiining
credit, and the signatures apprearing thereon are genuine. I authorize SIGNATURE OF APPLICANT
you to obtain such information as you may require concerining the
statements made in this application and that the sources to which you SIGNATURE OF SPOUSES/CO-MAKER
may aply are authorized to privide any information relative to this
application. may remain your property whether or not the credit is
granted.
SALES EXECUTIVE
 Isiah Chang/JSC
CONTACT NO: Principal:

Co-maker:
ENTS

HS