KFF Gorporation General Application Form

( Loan Program )
:.PERSONAL DATA

(G en Name) (Middle Name) (Family Name)

Date of Birth: Place of Birth:_______ ge: SeX:()Male()Female

Civii Status:( )Single ( )Manied ( )Separated ( )Window/er Number of Dependents:

City Addressi
Provincial AddressE
SSS No.: CS:S No.: Vote :D Non:
Drivers License No: Expiry Date:

.OTHER:NFORMAT:ON:

A.) Spouse Name:

(Given Name) (Middle Name) (Family Name)
( |Working ( )Housewife , Mobile Phone #:
Email:

B.) Parents Name:

Mother's Name :

Father'sName :

C.) Nearest Relative:

Name
Address
Contact No.

.SOuRCE OF:NCOME:
( )Employment
Company Name Net lncome
Address ,Tel.No.

( ) Business
Business Name Net:n me
Address Tel.No.

( )Allotment
Company Name Netlncome
Address Tel.No.

:V ASSETSE
b.) Bank Accounts
This is to authorize KFF Corporation Lending Investors, its executives, management, and representative to
check and verifv the followino bank acctrunts
Bank Name Type ofAccount Denomination Years of Existence
( )Checking ( )Savings ( )Dollar ( )Peso
( )Checking ( )Savings ( )Dollar ( )Peso
I am executing this authority for whatever legal purpose and intent it may serve.

(signature over printed name)

V. SKETCH

City Residence

Three Specimen Signature Three Initial Signature

1.)

2.)

3.)

I hereby CERTIFY that all information above are true and Conect:

(signature over printed name)