ONLINE APPLICATION FOR CREDIT

NOTE: Please select your status here:
Status: New CustomerExisting CustomerCo-maker

*Please do not fill in on this portion. FOR OFFICE USE ONLY

UNIT/ITEM APPLIED:

Referred By:

Down Payment(₱):

Term:

Monthly Installment:

Total Price(₱):

List Cash Price(₱):

Date Due:

Sales Type: OfficeAgent

Agent Name & Signature:

PERSONAL DATA & SOURCE OF INCOME

Name:

Tel. No / Cellphone No:

Res. Cert. No:

Date & Place of Issue:

TIN:

Present Address:

Length of Stay:

House:

Amortization:

Amortization: N/A

Lot:

Amortization:

Amortization: N/A

Name of Landlord and Address:

Previous Address:

Length of Stay:

Date of Birth:

Place:

Civil Status:

Name of Spouse:

Date of Birth:

Place of Birth:

Nearest Relative (Not Living with buyer):

Address:

Relationship:

Name if Children Studying:

Age:

School Attended:

Monthly Fee:

Civic Professional Societies Of which buyer is a member:

Position Occupied:

No. of Dependents:

Bank Account Where kept:(please check)Current

Life Insurance:

Amount of Policy:

Savings

Property Owned:

a) Real Estate Location:

Area:

Date Acquired:

Market Value:

Encumbrance Held By:

b) Personal:

Present Employer:

Tel. No / Cellphone No:

Address:

Position Occupied:

Years Employed:

Basic Salary(₱):

Other Compensation (₱):

Name of Superior:

Title/Position of Superior:

Tel. No / Cellphone No:

Previous Employer:

Tel. No / Cellphone No:

Address:

Position Held:

Length of Stay:

Salary(₱):

Other Compensation(₱):

Spouse's Employer:

Tel. No / Cellphone No:

Address:

Position Occupied:

Years Employed:

Basic Salary(₱):

Other Compensation(₱):

Name of Superior:

Title/Position of Superior:

Tel. No / Cellphone No:

Customer’s Nature of Business:

Address:

Years in Operation:

Capital Invested(₱):

Estimated Monthly Sales(₱):

Estimated Monthly Expenses(₱):

Estimated Monthly Profit(₱):

Spouse’s Nature of Business:

Address:

Years in Operation:

Capital Invested:

Estimated Monthly Sales(₱):

Estimated Monthly Expenses(₱):

Estimated Monthly Profit(₱):

FORM #01B-89

Other Sources of Income:

Monthly Income:

Personal Reference:

Address:

Relationship:

Tel. No / Cellphone No:

Credit Account with Other Companies Firm’s Name & Address:

Item Bought:

Original Balance:

Present Balance:

I HEREBY CERTIFY that the data contained in this application for credit are true and correct of my own personal knowledge. I agree that J MARKETING CORPORATION may verify the information given and may cancel my order on the sale on the ground of any misrepresentation made.

Date:

Applicant’s Signature:

IMPORTANT

Sales representative are not authorize to receive payment from customers except, in the form of check, bank draft or money orders, payable to J MARKETING CORPORATION.

Please indicate landmark of address/location

(FOR OFFICE USE ONLY)

Sales Representative:

Date Submitted:

Receiving Officer:

Price Checked by:

CREDIT APPROVED:

Date:

Upload Requirements:

Valid ID

Proof of Billing
(any proof of address)

Pay Slip/Remittance/Business Permit
(any of the 3)

I have read and agreed to the Terms and Conditions and Privacy Policy.

Online Credit Application Form

ONLINE APPLICATION FOR CREDIT

*Please do not fill in on this portion. FOR OFFICE USE ONLY

PERSONAL DATA & SOURCE OF INCOME

Property Owned:

FORM #01B-89

IMPORTANT

(FOR OFFICE USE ONLY)

Upload Requirements:

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