SALES CONSULTANT

CREDIT APPLICATION FORM Date

PERSONAL DETAILS
FIRST NAME MIDDLE NAME LAST NAME DATE OF BIRTH (MM/DD/YY)

Civil Status Married Single Widowed Separated

Nationality Filipino Other _________________________
Gender Male Female No. of Dependents

Length of Stay Years Months

Home Address Home Telephone
Mobile Number

Provincial
Address

Residential Owner (Mortgaged) Owner (Not Mortgaged)

Status Rental Living with Relatives / Parents

Owned Car? No Yes How many? Model / Brand

Main
Bank/Branch
Other Banks
Account No
TIN No.

SOURCE OF Walk-in Mall Inquiry Referral Other _______________________________

SALES Phone-In Office Sales Print Ads
WORK & FINANCES
Employment Private Government Self Employed

Employer /
Business Position / Title

Business Business Tel.

Address

Nature of Length of Stay

Business Monthly Income

SPOUSE'S PERSONAL DETAILS

FIRST NAME MIDDLE NAME LAST NAME DATE OF BIRTH (MM/DD/YY)

Employer / Position / Title

Business Business Tel.

Business Length of Stay

Address Monthly Income

Nature of TIN No.

Business Contact No.
CHILDREN'S DETAILS
Name Employer / Educational Institution's / Name & Address Contact Details

PERSONAL REFERENCES (Not Living with Borrower)

Name Employer / Educational Institution's / Name & Address Contact Details

VEHICLE DETAILS & FINANCING PREFERENCE

Make/Model
Chassis No. Engine No.
Accessories Cylinder Capacity
Unit Price Downpayment
Amount Finance Term
Purpose Private Business Public New Used
I/we certify that all the above information are true and correct to the best of my / our knowledge. I/We authorize you to verify and
investigate the above information from whatever sources you may consider appropriate. In addition, I / We hereby expressly and
unconditionally authorize PRINCE MOTOR CORPORATION (PMC) to disclose to any PMC subsidary, affiliate and accredited financing
companies any information regarding me / us.

Signature of Borrower Date Signature of Spouse / Co-Borrower Date