ASA Philippine Credit Cooperative

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15 Floor Prestige Tower, F. Ortigas Jr. Rd., Ortigas Center, Pasig City 1605 Philippines
Telefax: (+632)687-7558

LOAN APPLICATION FORM

DATE : __________________
TO: APCC GENERAL MANAGER

TYPE OF LOAN:
SALARY ADVANCE MOTORCYCLE ADVANCE HOUSING LOAN CAR LOAN
Fresh Brand :__________ Lot, Area :_____ Brand New
Roll-over Model :__________ House Construction Slightly-Used
Purpose of Loan:___________ Price :__________ House Renovation Brand:_______
_________________________ Purchase of new Unit Model:_______
Price : _______ Price :_______
FROM :Mr./ Ms.________________
I.D. NUMBER :_________________________ LOAN FREQUENCY : New Re-Availed
BRANCH :_________________________ Type of Existing Loan :____________
DESIGNATION :_________________________ Amount of Loan:___________________
CONTACT # :_________________________ Unpaid Balance: ___________________
BASIC PAY :Php_______________________
LENGTH OF SERVICE IN ASA :___________________
I would like to request/apply for a ________ loan/advance for the amount of_______________________
________________________________ (Php_________)
Expected date of release:____________________
RECOMMENDED BY:
______________________ ______________________ APPROVED
SUPERVISOR 1 SUPERVISOR 2
_______________________ ______________________ ______________________
SUPERVISOR 3 SUPERVISOR 4 APCC General Manager
*All recommending Supervisors should state full name and designation below their signatures.
*Applicants for Car and Housing Loan less than 10 years in service to the foundation shall have at least 2
Guarantors

AUTHORIZATION/DECLARATION

I agree to pay my _______Loan/Advance including the ___% interest of the total amount, to be payable
in __________ (__) monthly instalments starting on ____________. The amount shall be payable
without need of further demand.
To facilitate the payment of my advance, and for my convenience, I am authorizing APCC to collect and
deduct from my salary which I receive from my employer, ASA Philippines Foundation Inc. the amount of
(monthly amortization with interest) _____________, Double payment Single payment, starting
on ______________ and thereafter on a monthly basis, as payment for my salary loan, until it is fully
paid, including its interest.
I also agree that in the event that I am separated from my service with ASA Philippines Foundation Inc.,
whether for cause or voluntary, my loan shall be immediately due and demandable in full including its
interests. And APCC may deduct the remaining balance of my loan from my salary and final pay from ASA
Philippines Foundation Inc., regardless of the period stated herein and in my promissory note as per
APCC record. Furthermore, I undertake to settle all of my liabilities with APCC before my separation from
ASA Philippines Foundation. In the event that I fail to do so, I agree to pay a penalty in the amount
equivalent to one percent (1%) of the total amount of the loan including the interest, per month of delay,

____________________________________
(SIGNATURE OVER PRINTED NAME OF AVAILER)
CC: APCC File
C001-19