☐ New Application ☐ Additional Loan ☐ Renewal ☐ Restructuring

In case of loan renewal or restructuring, are there any updates from previous
submission? ☐ Yes ☐ No (If yes, kindly provide details)

BUSINESS LOAN APPLICATION FORM

☐ I n di vi dual ☐ S ol e- Pro p ri e tor s hi p
(Please mark the appropriate boxes and indicate N/A if not applicable)
A . B O R RO W E R A N D B U S I N E S S I N F O R M AT I O N 1
Name of Borrower:

(First Name) (Middle Name) (Last Name) (Suffix, if applicable)

Civil Status: ☐ Single ☐ Widow/er Date of Birth:(mm/dd/yyyy) Place of Birth: (Municipality/City, Province) Sex: ☐ Male
☐ Married ☐ Annulled ☐ Female
☐ Separated Citizenship:
Name of Spouse: Date of Birth: (mm/dd/yyyy)

(First Name) (Middle Name) (Last Name) (Suffix, if applicable)

Home Address: (Unit #, Building/House #, Street, Subdivision/ Barangay/ District, Home ☐ Owned (unencumbered) ☐ Rented
Municipality/ City, Province, Zip Code) address ☐ Owned (mortgaged) ☐ Living with relatives
ownership:
Length of Stay in Location: _______ years
Landline No. (Area Code, Number): Mobile No.: Email Address:
(____)-
Other Government-issued ID (Please specify type/number):
TIN: PhilSys:

Mother’s Maiden Name:

(First Name) (Middle Name) (Last Name) (Suffix, if applicable)

Registered Business Name (Trade Name):
Principal Business Address: (Unit #, Building/ House #, Street, Subdivision/ Barangay/ District, Business address ownership: Years the Business has
Municipality/City, Province, Zip code) been in operation:
Owned (unencumbered)
Is this similar to Home Address? Yes No (If no, kindly provide the details) Owned (mortgaged) _______ years
Rented Number of branches:
_______
Website/social media (Business): Indicate whether the business has:2
Female Manager/s
Female head officer for operations/administrative services
Nature of Business (Based on PSIC reference): Please specify business activity:

Business registration Date of Business Registration Expiry Date of Registration

Registration Number
(Check all that apply) (mm/dd/yyyy) (mm/dd/yyyy)
DTI
BIR
Barangay/Mayor’s Permit
Others (Please specify):
____________________________________________
_
Firm Size3 (Total assets exclusive of the land on which the business entity’s office, plant and equipment are situated) 4
Micro (not more than Php 3M) Small (Php3,000,001 to 15M) Medium (Php15,000,001 to 100M)
Annual Sales or Revenue: Number of employees: (Please indicate all paid employees and/or directly involved in business operations)
Php ___________________________ Full-time: _________________ Part-time/Contractual: _________________
Top Trade References (use additional sheet if necessary)
Goods Supplied/ Services
Name of Top Suppliers Contact Person Contact Number
Rendered

Name of Top Customers Goods Purchased/Services Availed Contact Person Contact Number

B . LOA N A P P L I C AT I O N I N F O R M AT I O N
Loan amount applied for (subject to the approval of the bank): Php ________________________ Tenor: ______ months
Proposed frequency of repayment5: Weekly Monthly Quarterly Annually Lump sum Others (Please specify): ________________
Loan Credit Line Loan Working capital (including receivables and inventory financing) Business expansion
Facility: Term Loan Purpose: Construction/Development of real estate Purchase of equipment/motor vehicles
Others (Please specify): Acquisition of real estate Purchase of biological asset
______________________ Loan takeout/refinancing Others (Please specify): ____________________

1
Additional borrower information such as but not limited to the following may be obtained using a separate sheet/form: co-borrower, dependents, questionnaire on
politically exposed person (PEP) and Foreign Account Tax Compliance Act (FATCA)
2
This information will solely be used to monitor information on business ownership/management in the country. Responses in this part will not affect the assessment and
approval of your loan application.
3
Subject to bank verification
4
The size of the firm is being collected for the BSP’s monitoring purposes.
5
As may be applicable
 Type of Unsecured Loan If secured, collateral/s and/or surety/ies offered:
Loan: Secured Loan Loan secured by real estate (e.g., land, building)
Loan secured by movable property
Receivables & any other claims to payment Intellectual Property
Equipment Others (Please specify):
Title documents (e.g., warehouse receipt, bill of lading)
Financial assets (e.g., deposits, tradable securities, Inventory _____________________________
company shares)
Loan backed by third party credit guarantee/continuing suretyship
C . F I N A N C I A L I N F O R M AT I O N
Source of Funds for Revenue Inheritance
Repayment of Asset Sale Salary/Allowance
Loans: Savings and/or Investment Others (Please specify): ____________________________________
Existing Deposit and E-money Accounts (please indicate top 3 in terms of outstanding balance size, use additional sheet if necessary) :
Name of Financial Year
Type of Account Type of Account Ownership
Institution Opened
Savings Checking E-wallet Others (Please specify) Personal Business/ Merchant

Savings Checking E-wallet Others (Please specify) Personal Business/Merchant

Savings Checking E-wallet Others (Please specify) Personal Business/Merchant

Existing Loans (please indicate top 3 in terms of loan amount, use additional sheet if necessary) :

Outstanding Collaterals offered

Date Granted Maturity Date
Name of Financial Institution Loan amount (If applicable, indicate if real estate,
(mm/yyyy) (mm/yyyy) Balance movable property, etc.)

Existing Credit Cards (please indicate top 3 in terms of credit limit, use additional sheet if necessary) :
Name of Financial Institution Credit Limit Outstanding Balance Type of Ownership
Personal Business
Personal Business
Personal Business
D . U N D E RTA K I N G / D E C L A R AT I O N
I/We hereby confirm that all information and supporting documents provided herein are true, accurate and complete and I/we ag ree to notify the financial institu tion of
any ch anges in any of the inform ation supplied. The financial institution can withdraw or cancel any loan approval if any m ajor inform ation an d supporting documents
are found to be materially inaccurate.
I/We authorize the financial institution to obtain relevant inform ation as it may require concerning this application.
I/We understand and agree that additional undertaking/declaration, not stated in this form, may be required by the financial institution.
I/We hereby agree that this application shall be subject to applicable laws (BSP circulars, rules and regulations) and policies of _______________________________ .
E. DATA PRIVACY CONSENT
In compliance with the requirements of the Data Privacy Act (DPA), I/we hereby authorize and give my/our consent to _______________________________
ORIX METRO Leasing and Finance on the general use
Corporation (OMLF)
and sharing of information obtained in the course of any transaction/s pursuant to m y ban king relationship with it. Personal information and sensitive person al
information 6 may be collected, processed, stored, updated, or disclosed by the bank:
a. for legitim ate bank-related purposes and requests;
b. to implem ent transactions which the borrower re quests, allows, or authorizes;
c. to comply with the bank's internal policies and its reporting obligations to governmen t au thorities under applicable laws; an d
d. to offer and provide new or related products and services of the bank, its affiliates and subsidiaries through mail, email, SMS or other means of
communication.
I/We confirm that I/we am/are aware that, in case of unlawful acquisition, inaccuracy, and error, I/we have the right to acce ss, update, dispu te, block, or correct certain
personal information, or withdraw my/our consent to the use of any information provided herein, subject to the righ ts and limitations under the DPA.
I/We understand that this consent shall continue to be in effect for ____5 years or until expiration of the records retention limits set by applicable banking laws,
whichever comes later.
I/We furth er warrant that, prior to submitting to the financial institution any inform ation (including personal information) of an individu al; I/we have obtained all
necessary authorizations and consents as may be required by applicable confidentiality and data privacy laws or agreement to en able th e bank to process such
information.
I/We understand that should I/we wish to access, update, dispute, block, or correct certain information, or withdraw consent to th e use of any of the inform ation
provided herein, subject to the rights and limitations under the DPA, I/we may communicate with the ____________________________
OMLF 's Data Protection Officer at
____________________________
[email protected], and may lodge complaints with, and/or seek assistance from the Nation al Privacy Commission.
I/We understand that my/our basic credit data, as well as any regular updates or corrections thereof, are mandated to be subm itted to th e Credit Inform ation
Corporation (CIC) pursuant to R.A. 9150 and its Implementing Rules and Regulations for consolidation and disclosure as may be authorized by the CIC. Consequently,
my/our basic credit data m ay thus be shared with other lenders authorized by th e CIC, and other reporting agencies duly accredited by the CIC, for the purpose of
establishing my/our creditworthiness.
I/We understand and agree that additional data privacy provisions, not stated in this form, m ay be required by the fina ncial institution.
I/We h ave read and understood and consent to be bound by all the term s and conditions stated above.

Signature above Printed Name of Date Signature above Printed Name of Date
Borrower Co-Borrower/Spouse

Third party credit guarantor and/or security grantor (i.e., a person or entity who grants a security interest in collateral to secure the obligation of the borrower)
Contact Information
Printed Name Affiliation Relationship with Borrower
(address, contact number)
1.
2.
3.

6
Name, address, gender, age, marital status, contact details, birthday, SSS/GSIS, TIN, education, employment or financial or medical information, spouse details, preferences,
behavior, and other information classified as "personal data", "personal information", or "sensitive personal information" under the DPA, and those of the Borrower's
authorized representative/s, as well as accounts, transactions, and communications.
Classification: GENERAL
By signing this form, I/we authorize ORIX METRO Leasing and Finance Corporation (OMLF) to share my/our personal data with
the subsidiaries and affiliates within the OMLF Group as well as agents or third parties that provide services or have contractual
obligations with the said Group.

I am/We are doing this:

• so that OMLF, its subsidiaries and affiliates, can further secure me/us from fraud, unauthorized and illegal transactions
and anti-money laundering and terrorist financing risks;
• so that my/our data can be used in the settlement of disputes or claims regarding my/our accounts through prosecution
or the defense of OMLF or its staff;
• so that I/we can be provided a customized experience and offered products and services within the OMLF Group that
are relevant and suitable to me/us; and
• so that OMLF can better perform its obligations to the law, rules and regulations, contracts, or orders from any courts or
quasi-judicial and administrative offices.

I/We acknowledge that OMLF is committed to protecting my/our personal data against unauthorized use or disclosure, by
complying with the Data Privacy Act of 2012 (Republic Act No. 10173), the Law on Secrecy of Bank Deposits (Republic Act No.
1405), the Foreign Currency Deposit Act (Republic Act No. 6426) and the General Banking Law of 2000 (Republic Act No. 8971),
as well as rules and regulations issued by the Bangko Sentral ng Pilipinas (BSP) and other regulatory bodies that uphold data
privacy.

I/We expressly authorize OMLF, in case my/our loan application is approved, to submit my/our basic credit data to the Credit
Information Corporation (CIC) in accordance with Republic Act No. 9510, otherwise known as the Credit Information System Act.

I/We acknowledge that OMLF may share data to its third-party provider such as but not limited to external auditor and legal
counsel. Service provider shall contractually agree to OMLF’s data protection procedures and ensure that the confidentiality of
all personal data is protected.

Pursuant to BSP Circular No. 472, as amended by Circular No. 549 and Circular No. 622, I/we hereby execute a Waiver of
Confidentiality of Information authorizing OMLF to conduct random verification with the Bureau of Internal Revenue (BIR) for
purposes of establishing the authenticity of the Income Tax Return (ITR) and accompanying financial statements submitted
by me/us in connection with loans, other credit accommodations and credit lines granted, renewed or extended by the said
financial institution.

I am/We are also aware that the details of how my/our personal data will be processed, as well as the rights available to me/us,
are listed on OMLF’s privacy policy statement, available on www.orix.com.ph.

If I/we want to access, update or correct my/our personal data, or withdraw my/our consent, I/we know that I/we have the
following options:
• Send a letter to my/our branch of account;
• Email the Data Protection Officer at [email protected]; or
• Use OMLF’s website.

If I/we withdraw my/our consent to use my/our data, or if I/we settle and close my/our engagements with OMLF, I/we understand
that OMLF has five (5) years to delete and securely dispose of my/our data.

AMLA Compliance
To enable OMLF to comply with local and international anti-money laundering laws and regulations, I/we hereby authorize the
Company to disclose to local and/or international government entities, subsidiaries and affiliates, and/or its local and/or foreign
correspondent banks, information which shall include, but not limited to, the following personal information: e.g. birthdate,
birthplace, employment, profession, business, contact numbers, date when account was opened. The foregoing includes the
authority of OMLF to supply any supporting transactional documents when required by any of these entities. I/We release and
hold the Company, its directors, officers, staff, representative and/or agent, free and harmless from any liabilities, suits, actions,
losses, and/or damages that may arise out of such disclosure.

______________________________________ __________________
Customer’s Signature over Printed Name Date

______________________________________
Company Name
 CHECKLIST OF SUPPORTING DOCUMENTS

The checklist enumerates the types of supporting documents that the borrower may present to facilitate the financial institution’s
evaluation of the loan application. Borrowers are not expected to provide all the listed documents but only those that are
applicable to the loan application.

After the initial loan application screening, additional information (using separate sheet or form) may be requested to further
evaluate the loan application and the security being offered. The financial institution may also require additional documents, as
deemed necessary.

For the financial institution to better consider the application, additional post-approval documents not specified in the list may be
required, as applicable.
Basic Documents Security Documents (Please check applicable item/s)
Filled-out and signed application form Photocopy of Transfer Certificate of Title (TCT)/
Clear copy of one (1) valid government-issued ID Condominium Certificate of Title (CCT)
Photocopy of Tax Declaration (for land and
Marriage contract, if applicable
Improvement)
Location/Vicinity Map
Proof of business registration: (Please check applicable item/s) Land Transportation Office (LTO) Official Receipt (OR)/

Certificate of Registration with Bureau of Internal Certificate of Registration ( CR) or Deed of Sale of Motor
Revenue (BIR) Vehicle
Certificate of Registration with Department of Trade Reservation Agreement or Contract to Sell or
and Industry (DTI) Statement of Account (for Deed of Assignment (DOA)
Certificate of Registration with Securities and accounts only)
Exchange Commission (SEC)
Certificate of Registration with Farmers and
Fisherfolk Enterprise Development Information System If secured by a Continuing Suretyship:
(FFEDIS) Basic Documents (as enumerated in this form) of the
Surety
Barangay Permit
Income Documents (as enumerated in this form) of the
Mayor’s Permit
Surety

Personal Income Documents (Please check applicable item/s) If construction loan

Latest Income Tax Return (ITR) or BIR Form 2316 Building/Floor plan of proposed improvement
Latest payslip for the past 2 months Bill of materials
Certificate of Employment (COE) with salary or Specification of proposed finishes
Employment Contract Building permit
Latest crew contact (for seafarers)
Proof of remittance for the past 6 months If refinancing/loan take out
Bank statements or photocopy of passbook for the Statement of Account from current lender and official
past 6 months receipts for the past 3 months
Lease contract (for rental income) Others
Proof of other income: Appraisal fee
_________________________________________ Additional security documents (please specify):
______________________________________________
Business Documents (Please check applicable item/s)
Photocopy of Audited Financial Statements for the Post-approval requirements for real estate collateral-backed
past 3 years with latest ITR or Photocopy of in -house loans
financial statements or pre-operating financial statements (Please check applicable item/s)
Business Plan/Business Proposal Original owner’s copy of TCT/CCT
Photocopy of franchise agreement, if any Original Tax Clearance
Business background/Company profile Certified true copy of latest Tax Declaration
Photocopy of purchase agreement Insurance policy/ies (for properties with
Others (please specify): improvements)
____________________________________ Master Deed of Declaration (for condominium only)
Photocopy of latest full year Real Estate Tax Receipt
(RETR)
Price quotation of the property (for property
Other Pre-application Requirements
acquisition)
Billing statement of utilities for the past 3
Affidavit of Consent to Mortgage Family Home
months
Others (please specify): ________________________________
Statement of Account from current lender and
official receipts for the past 3 months (if loan
Other post-approval requirements
purpose is refinancing/loan takeout)
General Information Sheet (GIS), if applicable
Others (please specify): _______________
Special Power of Attorney, if applicable
Certificate of Ownership for movable property (e.g.,
motor vehicles, etc.)

Classification: GENERAL