CO-SIGNER'S STATEMENT APPLICATION
Unit 2401, 24th Flr. Antel Corporate Center, 121 Valero St. Salcedo Village, Makati City
Tel. # 845-10-33 to 37/ Fax # 845-3272
Or Download PDF Form
Makati City, Philippines
Date
I am agreeable to sign with the applicant
covering P/N bond/Bond applied for by him from your company in the amount of P
in favor of
. I am aware of the responsibility which I will assume in signing with
. I am aware that you will relyon the truth of the following statement in consideration thereof.
I authorized you obtain such information as you may require concerning the statements made hereunder and agreethat this document shall remain your property whether or not the bond is granted.
BASIC INFORMATION
Name
Community Tax Cert.
Community Tax Cert Issued Date
On
ACR
Business Address
Tel No.
Residence Address
Salaries, Wages per year P
Income from business P
Amount per year P
Married/Single
Single
Married
Divorced
Widowed
Living with husband or wife
Number of dependents
If employed please rate:
Name of Employer
Address
Tel Nos.
No. of years with employer
Kind of business of employer
Position occupied by co-maker
Name & Title of superior
If in business for self, please rate:
Firm or Trade Name
Address
Tel Nos.
Kind of business
How long
Capital Invested
Sole Owner or partner
Trade references
Address
How long
Bank Account – Where Kept:
Current
Savings
REAL ESTATE
Real Estate Owned – PLEASE SUBMIT XEROX COPY OF TCTS (FRONT & BACK PAGE)
Title No.
Date Acquired
Location
Area of Land
Assessed Value
Amount
Held by
Title No.
Date Acquired
Location
Area of Land
Assessed Value
Amount
Held by
Title No.
Date Acquired
Location
Area of Land
Assessed Value
Amount
Held by
Title No.
Date Acquired
Location
Area of Land
Assessed Value
Amount
Held by
RELATED INFORMATION
Life Insu Co.
Amount P
Co-signer will state whether applicant is related to him and if so in what manner
How long he has known
Co-signer will state whether he has ever been a borrower or co-maker on a personal note at any bank
Cosigner Reference Name 1
Cosigner Address 1
Cosigner Reference Name 2
Cosigner Address 2
I affirm and certify that the foregoing representations are true, correct and accurate.
PLEASE SUBMIT THIS WITH YOUR LATEST INCOME TAX RETURN
Upload Signature
Signature of Co-signer
SUBSCRIBED AND SWORN TO BEFORE ME
this
day of
, affiant exhibiting to me his/her CommunityTax Cert No.
issued at
on
.
NOTARY PUBLIC
Send a copy to my email
SUBMIT