Application Form for Individual Borrowers

Thank you for taking interest in PSBank’s Auto Loan. Please completely fill out this application form or put N/A on fields that are not applicable to you. All fields marked
with asterisk (*) are mandatory fields. Application with incomplete information will not be processed. Please print your answers using BLACK ink only.
Date of Application Dealer Sales Agent Branch Application No.

Brand Year Model Cash Price Downpayment Term (in months)

Model Type of Vehicle Amount Financed Add-on Rate (AOR)

Brand New Pre-owned Reconditioned

PURPOSE OF LOAN
Personal Business Public Use Others, pls. specify

INFORMATION OF BORROWER CO-MAKER

*Name (Last name, First name, Middle name) Mr. Ms. Mrs. Sr. Jr. Others Gender
Male
DELA CRUZ, Jan Piola, Largo Female
*Nationality Residency *Birthdate (mm/dd/yy) Age *Birthplace
Filipino Resident (e.g. Filipinos, sea-based OFWs, Aliens with ACR or Special Retirement Visa ID, etc.)
Others Non-Resident (e.g. Aliens, Filipino immigrants, land-based OFWs with contract to work abroad for more than a year, etc.) 06/02/99 24 Quezon City
Educational Attainment Civil Status * TIN / PhilID (National ID) No. SSS / GSIS No. If co-maker, pls. specify relation to
Elementary High School Vocational Single Legally Separated Principal Applicant
College Undergraduate Postgraduate Married Widow / Widower 389-996-481-000 35-0543963-6
*Present Address (House No./ Floor/ Unit No./ Block No./ Lot No./ P.O. Box No./ Bldg./ Apartment Name/ Street Name/ Village/ Subdivision/ Phase/ Barangay/ Barrio/ Municipality/ Province/ City/ Zip Code/ Country)

Unit 509A, Bldg. 5, Field Residences, Dr. A. Santos Ave., Brgy. San Dionisio, Parañaque City, 1700
*Previous Address (House No./ Floor/ Unit No./ Block No./ Lot No./ P.O. Box No./ Bldg./ Apartment Name/ Street Name/ Village/ Subdivision/ Phase/ Barangay/ Barrio/ Municipality/ Province/ City/ Zip Code/ Country)

Blk 28 Lot 30, Westmont St., Savannah Green Plains Phase 3, Brgy. Cuayan, Angeles City, Pampanga
Home Ownership
Owned
Mortgaged to Term Amort./Mo. PhP Length of Stay
(Bank or Financial Institution)
7
Rented from Rent / Mo. PhP Years
(Landlord’s Name and Contact No.)
Living with Parents / Relatives Relationship Months
(Names)
*Residential Telephone No. 8800-8748 *Cellphone No.
(For non-Metro Manila, please indicate the area code) 0945-597-0810
*Email Address Your preferred mailing address: Residence Office Address Business Address
[email protected]
Employment
Source of Income Status of Employment
Locally Employed OFW Immigrant OFW Non-Immigrant Unemployed Others Permanent
Private Private Private Remittance / Allottee
Probationary
Government Government Government Pension / Retired
Self-employed Self-employed Self-employed Student Contractual

If employed, please state: If in business or in practice of profession, please state:

Company Name Business Name YOUEN BUILDERS OPC
Office Address Position in the Company Unit 309B, Bldg. 3 Field Residences, Dr. A. Santos Ave., Parañaque City
Business Address
Non-Officer
Business Website Address
Company Website Address Jr. Officer Construction
Nature of Business / Work
Nature of Business Supervisor
Job Title Middle Manager Length of Operation Years Months
Sr. Officer 8800-8748
Length of Stay Years Months Office Phone / Fax No.

Office Phone / Fax No. Name of Previous Employer / Business Century Iron Works, Inc.
If OFW, please state : Country of destination Employment base: Land Sea Air

Dependents

1. Name Age Level

School Type of School Public Exclusive Private Coed

2. Name Age Level

School Type of School Public Exclusive Private Coed

INFORMATION OF SPOUSE
*Name (Last name, First name, Middle name) Mr. Ms. Mrs. Sr. Jr. Others Gender
Male
Female
*Maiden Name (Last name, First name, Middle name) *Nationality *Birthdate (mm/dd/yy) Age *Birthplace
Filipino
Others
Educational Attainment * TIN / PhilID (National ID) No. SSS / GSIS No.
Elementary High School Vocational
College Undergraduate Postgraduate

Employment
Source of Income Status of Employment
Locally Employed OFW Immigrant OFW Non-Immigrant Unemployed Others Permanent
Private Private Private Remittance / Allottee
Probationary
Government Government Government Pension / Retired
Self-employed Self-employed Self-employed Student Contractual

If employed, please state: If in business or in practice of profession, please state:

Company Name Business Name
Office Address Position in the Company Business Address
Non-Officer
Business Website Address
Company Website Address Jr. Officer
Nature of Business / Work
Nature of Business Supervisor
Job Title Middle Manager Length of Operation Years Months

Length of Stay Years Months Sr. Officer Office Phone / Fax No.

Office Phone / Fax No. Name of Previous Employer / Business

Rev. Jan 2023
 STATEMENT OF INCOME AND EXPENSES*
Borrower Spouse Total
Gross Monthly Income PhP 60,000 PhP PhP 60,000
Gross Monthly Expenses PhP 20,000 PhP PhP 20,000
Net Monthly Income PhP 40,000 PhP PhP 40,000

STATEMENT OF ASSETS AND LIABILITIES*

ASSETS Details (Name of Bank, Etc.) / Type / Description Amount / Estimated Value
Cash on Hand & with Banks PhP
Real Estate Property/ies UNIT 509A BLDG. 5 FIELD RESIDENCES/Under SMDC PhP 4,900,000
Motor Vehicle/s PhP
TOTAL ASSETS PhP 4,900,000

LESS: LIABILITIES Type Bank Amortization Outstanding Balance

Personal / Salary Loan PhP PhP
Loans Car Loan PhP PhP
Housing Loan PhP PhP
Credit Card Credit Card Number Expiry Date Credit Limit Outstanding Balance
Company
Credit Card PhP PhP
PhP PhP
TOTAL LIABILITIES PhP
NET WORTH PhP
*as required by the Bangko Sentral ng Pilipinas under BSP Circular 622
PERSONAL REFERENCES
Name Address Contact Number

CREDIT / BANK REFERENCES

Bank Type Account No. Monthly Amortization Outstanding Balance Maturity Date

SOURCE OF PRODUCT INFORMATION DO YOU HAVE A RELATIVE WORKING IN PSBANK?

How did you learn about PSBank Auto Loan?
Yes No
TV / Radio Website Flyer / Poster / Streamer Newspaper / Magazine Social Media
If yes, please state:
PSBank Personnel Name
PSBank Client Name Name
Agency Name Monica Castilla
Relation
Others, pls. Specify

HIGHLIGHTS OF TERMS AND CONDITIONS

Product Features - PSBank Auto Loan with Prime Rebate is a Term Loan facility. FEES AND CHARGES
Loan Range: Minimum of PhP100,000 for brand new cars / Minimum of PhP300,000 for 2nd hand units.
Terms: 12 to 60 months
A.) BOOKING FEES AND CHARGES:
Interest Rate: Based on prevailing interest rate at time of loan booking. CHATTEL MORTGAGE FEES + INSURANCE + OTHER CHARGES (RD Registration fee + LTO Encumbrance (out of town) fee)
Prime Rebate Feature: Allows clients to get a “discount” on his/her loan when he/she makes advance or excess payments
B.) POST-BOOKING FEES AND CHARGES:
on his/her monthly due.
DUE DATE EXTENSION FEE Due date extension fee is computed as:
(accrued interest from old due date to new due date) Outstanding Balance x Rate x number of days / 360
Events of Default – Each or any of the following shall constitute an event of default.
a.) Client fails to pay the amortization or interest or any amount due; SERVICE FEE FOR CERTIFICATE OF A certification fee of PhP100 shall be charged plus a notary fee of PhP500 if
ENCUMBRANCE FOR LTO REGISTRATION Certificate of Encumbrance for LTO registration is notarized.
b.) Client defaults or fails to pay the loan or any other loan or credit accommodation with the Bank, its
subsidiaries or affiliates or any third party or creditor, whether as borrower, surety or guarantor; PROCESSING FEES FOR CHANGE OF COLLATERAL -PhP5,000 shall be charged for amendments or change of collateral.
c.) Client violates any of the T&C of the agreement; AND CONVERSION OF UNIT TO PUV -PhP10,000 shall be charged for conversion of unit to PUV.
d.) Client makes a representation or warranty in any credit or loan documents that are incorrect or untrue in LATE / NON-SUBMISSION FEE ON INSURANCE PhP3,000 shall be charged for late / non-submission of insurance policy
any material respect; POLICY RENEWAL renewal document.
e.) Lost, destroyed, damaged or change in form and use of mortgaged property. The property/ies COLLECTION FEE IN CASE OF DEFAULT A collection fee amounting to 3% of the monthly installment or amount
mortgaged shall be deemed lost if Client fails to give additional security (in lieu of the damages, etc. on the due shall also be charged in case of default.
property/ies) to the Bank. LATE PAYMENT PENALTY FEE 5% per month or a fraction thereof shall be added on each unpaid
installment from its due date until fully paid.
Consequences of Default – In case of default, the Bank may, without need of notice or demand, exercise any or all of the ATTORNEY'S FEES AND LIQUIDATED DAMAGES In case of default and no legal action is filed, borrower shall pay an additional
following remedies. sum equal to 10% of the amount due as attorney’s fees. In case of litigation,
a.) The whole amount remaining unpaid including (interest, fees and charges) shall immediately become borrower shall pay an additional sum equal to 25% of all amount outstanding
due and payable; as attorney’s fees and the further sum of 20% as liquidated damages, in
addition to cost and other expenses of litigation.
b.) Extrajudicial /Judicial foreclosure;
c.) Exercise the right to offset and/or legal compensation; ISSUANCE OF CANCELLATION DOCUMENTS • 1st issuance: Pay Notarial Fee of PhP500
d.) Deliver the mortgaged property to the Bank, at Client’s own expense; • 2nd and every issuance thereafter:
- Notarial Fee: PhP500
e.) In case of breach of the Terms & Conditions client expressly waives the term of 30 days as the period - Processing Fee: PhP2,000
which must elapse before the Bank shall foreclose the mortgage.
EARLY SETTLEMENT PROCESSING FEE • PhP10,000
Customer Complaints, Concerns and Other Queries - In case of complaints, concerns and other queries regarding the loan, • NO CHARGE: - if remaining term is equal or less than 6 months
the Client may contact the Bank's 24/7 Customer Experience Hotline at (02) 8845-8888; text (63)998-8458888; or e-mail at - if outstanding balance does not exceed PhP50,000
[email protected]. The Client may also visit the PSBank Head Office, Mezzanine Floor, PSBank Center, 777
SAFEKEEPING FEE A fee of PhP2,000 shall be charged if collateral loan document/s is/are unclaimed
Paseo de Roxas corner Sedeno Streets, Makati City, form 8:30 am to 5:30 pm, Monday to Friday (except holidays). The Client after 90 days to 120 days from loan closure date. An additional fee of PhP1,000
may also LiveChat with the Bank at www.psbank.com.ph or ISSA Chatbot at Facebook.com/psbankofficial shall be charged for every 30 days exceeding the 120-day period.

The Bank is a regulated entity, and supervised by the Bangko Sentral ng Pilipinas (BSP). The Client may contact BSP at Note: All aforesaid fees and charges will take effect immediately and may be cancelled or modified anytime at the Bank’s sole
(02) 8708-7087 / [email protected]. discretion. The Bank may impose other fees and charges incidental to the loan provided with prior notice to Client.

CLIENT’S CONSENT/AUTHORITY AND WAIVER OF CONFIDENTIALITY/PRIVACY OF PERSONAL AND OTHER INFORMATION FOR THE BANK’S LEGITIMATE
PURPOSES/NEEDS, AND TERMS AND CONDITIONS OF LOAN APPLICATION/APPROVAL
1. The undersigned loan applicant/borrower (hereinafter the “Client” regardless of number) certifies the correctness of all the personal, Above consent shall continue to be valid and subsisting for as long as my relationship with the Bank exists and until the expiration
sensitive, privileged, financial, and other information (collectively referred to hereinafter as “Information”) provided by him in this Auto Loan of the applicable records retention period set by the relevant banking laws and regulations for account closure including the
Application Form, and in the course of his loan application with Philippine Savings Bank (the “Bank”), including the information which may period internally set by the Bank until destruction and/or disposal of my records, unless earlier withdrawn in writing.
be obtained from his income tax returns, financial statements, credit transactions and all other documents (”Supporting Documents”)
submitted to the Bank in support of his loan application. Jan Piola Dela Cruz
______________________________________________ _____________________________________________
(Signature Over Borrower’s / Co-Maker’s Printed Name) (Signature Over Spouse’s Printed Name)
2. In providing the Information and related Documents to the Bank, the Client hereby authorizes the Bank, without need of prior notice,
to use, process, store, make profile, receive from, and/or share to any of its affiliates and/or subsidiaries within the Metrobank Group, or its To support the Bank’s reasonable efforts to protect the Information against unauthorized use or disclosure, and ensure that the
agents or service providers, or third parties (including but not limited to vendors and credit bureaus), whether in or outside the above authorities given are carried out by the Bank without any conflict, the Client hereby dispenses his/her rights to
Philippines, which provide related services or have contractual obligations with the Bank, or any government agency/regulatory confidentiality and privacy of the Information and such other rights as may be provided under Republic Act (RA) No. 1405 (Law
body/branch (including but not limited to Bangko Sentral ng Pilipinas, Anti-Money Laundering Council, and Credit Information on the Secrecy of Bank Deposits), RA No. 6426 (The Foreign Currency Deposit Act), RA No. 8971 (General Banking Law of 2000), RA
No. 10173 (Data Privacy Act of 2012), or all other applicable laws, which are inconsistent with those authorities.
Corporation), which in turn is/are authorized to disclose to and/or receive from the Bank, the Information, relevant account information /
data/opinion pertaining to the Client, and any and all other information pertaining to Client’s account/s now existing or which may 3. The Client understands that the Bank may disapprove his loan application, revoke prior loan approvals, or terminate existing loan
hereafter to be opened, whether or not secured and/or assigned as collateral, for the following purposes: (a) in order to commence and availments on the ground of misrepresentation and/or concealment of the Client’s Information, whether willful or not, without
facilitate the efficient delivery, administration, operation, and/or implementation of loan and other products and services of the Bank; (b) prejudice to any other legal remedies that the Bank may take.
for the protection of the Client or the Bank against fraudulent, unauthorized, or illegal transactions; (c) in the validation, verification,
and/or updating of the Information and related Documents; (d) in order for the Bank to enforce its rights or perform its obligations by 4. The Client understands that the approval of his loan application shall be at the sole discretion of the Bank, and subject to:
reason of any law, rules and regulations, contract, or orders from any court or quasi-judicial and administrative offices with corresponding a) The Bank’s existing credit policies and procedures on its Auto Loan Facility;
duty to keep such information confidential in accordance with the Bank’s Data Privacy Policy; e) in the registration of the security interest b) Existing rules and regulations of the Bangko Sentral ng Pilipinas;
with the Personal Property Security Registry (PPSR); and (f) in the prosecution or defense of the Bank or its directors/officers/employees c) Payment by the Client of all fees and charges relative to the processing of his loan application;
with regards to disputes or claims pertaining to the products and services of the Bank. d) Submission by the Client of all documentary requirements and compliance with all other conditions imposed by the Bank fo the approval of his loan application
as prescribed under existing Bank credit policies or those that may be prescribed by the Bank’s Legal Department;
In addition to the above authorities, e) The terms and conditions of the Loan/Mortgage Agreement and this Loan Application Form;
f) Submission to the Bank of the Certificate of Registration/Official Receipt (CR/OR) issued by the Land Transportation Office on the vehicle. The Client shall
I consent: _____________________________ __________________ follow-up with the dealer, from whom he acaquired the vehicle, the issuance, availability, and submission to the Bank of the original CR/OR, and hold the Bank
(Borrower’s / Co-Maker’s signature) (Spouse’s signature) harmless and free from any liability in the event the CR/OR is not submitted.

I do not consent: _______________________ __________________ In case of disapproval of the Client’s loan application, the Bank shall not be obliged to disclose the reason/s for such disapproval.
(Borrower’s / Co-Maker’s signature) (Spouse’s signature)
5. The Client authorizes the Bank to send its correspondence or notice to the Client via SMS/text, email, personal delivery or other
for the Bank to share my personal data to its affiliates and/or subsidiaries within the Metrobank Group for legitimate business purposes means of communication at the option of the Bank.
such as to provide me relevant marketing information and promotional advisories/campaigns and for them to carry out market research 6. The Client‘s loan application may be withdrawn or canceled at any time prior to booking, without incurring additional charges.
, customer profiling, and data analytics so they can send me customized communications and improve my banking experience. I will be The Client shall course all complaints or concerns, if any, at the Bank’s Customer Experience Group or Indirect Auto Loans Channel
contacted by automated or electronic means including email, phone, mobile applications, and post or automated calls. I understand that Department.
adequate security measures shall be employed to protect my personal data.
Sep. 25, 2023 7. The Loan Application Form and all Supporting Documents shall remain the Bank’s property and the same may be used in
accordance with the above-mentioned paragraph no. 2 of the terms of this Auto Loan Application Form at the Bank’s discretion
Signature of Principal Borrower / Co-Maker Date whether the loan is granted or not.
Signature Verified, Authenticated, Approved by:

Signature of Spouse Date Automatic Debit Arrangement Account Number

Rev. Jan 2023