Applicant
*
Last Name
First Name
Middle Name
Age
*
Date of Birth
*
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Length of Stay
Ownership
*
Owned
Mortgage
Rented
Used Free
Status
*
Single
Married
Separated
Widowed
Email
*
example@example.com
Mobile Phone Number
*
-
Area Code
Phone Number
Telephone Number
-
Area Code
Phone Number
Citizenship
*
No. of Dependents
Previous Address
Length of Stay
1. Spouse/Co-Maker
Last Name
First Name
Middle Name
2. Spouse/Co-Maker
Last Name
First Name
Middle Name
Date of Birth (Spouse/Co-Maker)
-
Month
-
Day
Year
Date
Status (Co-Maker)
Single
Married
Separated
Widowed
Email (Spouse/Co-Maker)
example@example.com
Mobile Phone Number (Spouse/Co-Maker)
-
Area Code
Phone Number
Telephone Number (Spouse/Co-Maker)
-
Area Code
Phone Number
Citizenship (Spouse/Co-Maker)
Source of Income
Applicant
Applicant
*
Employment
Business
Emp. / Bus.
*
Address
*
Position
*
Telephone Number
*
-
Area Code
Phone Number
Length of Stay
*
Previous Employer
Address
Spouse/Co-Maker
Spouse/Co-Maker
Employment
Business
Emp. / Bus.
Address
Position
Telephone Number
-
Area Code
Phone Number
Length of Stay
Previous Employer
Address
Collateral / Security
Unit / Model
*
LCP
Dealer
Sales Consultant
*
Joal Canapi
Arden Medina
Ryan Deliva
Abigael Deleon
Alvin Nanud
Catherine Gercayo
Cris D. Viloria
Czar Jay Quiambao
Dannah Baybayan
Efraime Baruel
Gerald Louie Mintalar
Geralfen Deuna
Gervin Yatco
Gilbert Cuyom
Gilberto Batain
Hanz Ocay Jr.
Jan Ritchival Ibuna
Jeanno Reyes
Jefferson Morales
Jerold Jess Rodriguez
Jessierel Karamihan
Jojo Beredo
Jomean Cruz
Jorge Castillo
Joyce Llagas
Kerwin Yap
Krislyn Julian
Mabel C. Marcaida
Mark Anthony Piston
Mark Francis Rios
Mary Rosalie Macleod
MC Kelvin Camacho
Melvin Datu
Mike Allen Laurenciana
Naithan Pobeda
Nelson Regenio
Sarah L. Sidro
Raphael Cera
Reymond Elopre
Rhodjer Lalimarmo
Rommel Hernando
Rose Anne Balobalo
Shermil Alcayde
Vilmark De Jesus
Down Payment %
*
20%
25%
30%
35%
40%
45%
50%
Loan Value
Term
*
24 Months
36 Months
48 Months
60 Months
Place of Use
A.O.R
Purpose
*
Private
Business
Public
Monthly Income / Expenses
Applicant (Php)
*
Spouse (Php)
*
Other Income
SUB-TOTAL
LESS:Living Expenses
LESS:Rental
LESS:Amortizations
TOTAL
Liabilities
Creditor / Bank
Type of Loan
Amount
Maturity
Outs Balance
Total
Data Privacy Consent
I hereby authorize HYUNDAI SANTA ROSA, LAGUNA to process and share my personal data to any of its accredited banks, which is likewise authorized to receive, use, collect and process my personal data, for the purpose of financing my purchase of auto vehicle/s from the dealer, or assignment of the dealers rights to accredited bank, including verification, customer profiling,cross-checking and credit investigation. In this regard, my personal information may also be shared with accredited banks' branches,subsidiaries, affiliates, representatives, or third party service providers. I am also aware that the details of how my personal data will be processed and the rights available tome are listed in the accredited bank's Privacy Policy Statement. If I want to access, update or correct,my personal data, or withdraw my consent, I know that I may contact the customer service on HYUNDAI SANTA ROSA, LAGUNA and and its accredited banks.
Signature
*
Clear
Date
*
-
Month
-
Day
Year
Date
Submit
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