Motorcycle Loan Application FormHome » Loans » Consumer Loans » Motorcycle Loan Application FormStep 1 of 6 - Loan Details16%Loan DetailsBrand*Select OneBrand NewUsed / RepossessedModel*List Cash Price* Personal InformationFirst Name*Middle Name*Last Name*Sex*MaleFemaleHome Address*Yrs. in Address*Mobile No*Previous Address*Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Civil Status*SingleMarriedWidowedSeparatedHome OwnershipOwned, not mortgageOwned, mortgageRentedMortgage withMonthly MortgageStaying with relatives / parentsSelect OneYesNoRented fromMonthly Rent Income DetailsName of Employer / Business Name*Business Address*Position*Years in Work / Business*Tel No Family InformationName of Spouse / Co-makerDate of BirthMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Income Details Co-Maker Information (other than spouse )Name*Home Address*Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Tel No Terms and Conditions I agree with the Terms and Conditionsl/we hereby confirm that the information herein and the documents l/we have submitted are true and correct, and l/we authorize Robinsons Bank Corporation (the"Bank")to verify and investigate the same from what ever source it may consider appropriate.l/we understand that my/our falsification of any of the information, including the enclosed/attached documents, if any, is sufficient ground for legal action(s) against me/us and the rejection of my/our loan application. I/we further understand that should my/our loan application be denied, the Bank has no obligation on its part lo furnish me/us with reason for such rejection and/or to return my/our application form and documents.I/we also confirm that the proceeds of the loan which l/we have applied shall not be used in any speculative, illegal, and/or criminal activity. I/we likewise authorize the Bank to disclose any information relating to the loan granted to me/us to government administrative and regulatory bodies, financial institutions, credit information bureaus and any other organization performing similar functions.l/we confirm that l/wehavereadand understood the terms and conditions herein provided and that l am/we are entering into this transaction with my/our full consent, and that I am/we are considered indebted to the Bank upon receipt of the loan proceeds.I/we agree to indemnify and hold the Bank, its directors, officers and employees free of any claims l/we may have against the broker-referror who referred me/us for the Bank's financing.l/we hereby authorize the Bank to conduct business, deposit, employment verifications, credit checkings, property inspections, and other such related inquiries relative to information indicated in this application.l/we hereby authorize the Bank to conduct random verification with the Bureau of Internal Revenue (BIR) to establish the authenticity of my/our Income Tax Return (ITR) and other submitted financial statements and hereby waive the confidentiality of any personal information obtained in the course of verification.l/we also knowingly acknowledge and expressly authorize the Bank during the effectivity of this Agreement to regularly submit and disclose my/our basic credit data to the Credit information Corporation(ClC) and/or other credit bureau in the Philippines, as well as any updates or correction thereof. Further, l/we also knowingly acknowledge and expressly authorize the Bank and the credit reporting agencies/credit bureau the sharing of my/our basic credit data or any information in relation to my/our credit data among the Banks, other lenders authorized by the ClC, and credit reporting agencies/credit bureau duly accredited by the ClC.I/we hereby allow and authorize Robinsons Bank, its subsidiaries, affiliates, agents and representatives to offer specially selected products and services to me/us through telephone/mail/e-mail/fax/SMS. I/we signify our interest in receiving invites to the marketing initiatives, campaigns, and programs of the Bank, and its controlling shareholders, subsidiaries, affiliates, and agents. In this regard, I hereby authorize the Bank to share my/our personal information to its controlling shareholders, subsidiaries, affiliates, and agents in order to facilitate the sending of invites to me/us. This consent and authorization remains valid, effective, and subsisting until otherwise revoked or cancelled in writing by me/us.PhoneThis field is for validation purposes and should be left unchanged.