Business Permit in Makati City APPLICATION FORM Purpose of leasing

							                                                                       APPLICATION FORM
                                                            Purpose of leasing/loan requirements              NEW                        REAVAILMENT
                                                                  Asset Purchase                              Working Capital            Others               Recent Photo
G/F ODC Building, 219 Salcedo Street                        Amount Applied for
Legaspi Village, Makati City                                                                PhP
Tel. Nos. 8938843/8179847 Telefax: 8939141                     Payment Term                                                      years
                                                       BUSINESS/COMPANY INFORMATION
Business Name                                                                                                                            Phone(s)
Complete Address                                                                                                                         Fax
Date of Registration                                                                   Start of Operations                               Email/Website
Nature of Business
          Agricultural            Trade                           Mining and Quarrying                        Manufacturing              Construction
          Real Estate             Public Utilities                Services                                    Others (pls. specify
Product Lines                                                     Trade Name                                                     Trade Marks/Patents Owned (if any)




Membership in Industry Association (if any):
                                                                  OWNERSHIP MANAGEMENT
Type of Business
          Sole Proprietorship                                     Partnership               Domestic             Multinational           Others
                                                                                           Corporation           Corporation
                   Name of Owners/                                      % of Ownership                        Name of Officers                           Position
                Stockholders/Partners




                          Total                                               100%
                                                             AFFILIATES AND SUBSIDIARIES
                            Name                                                   Ownership                                                   Address




                                                                    OPERATING FACILITIES
a) Plant Site/Warehouse                                                              Branch/Outlets
Address                                                                              Address

                         Owned                                    Mortgage                               Owned                           Mortgage


                         Mortgaged with/Leased from                                                      Mortgaged with/Leased from
b)Vehicles, Equipment and Machinery, etc. (use separate sheet if necessary)
                       Make/Model                                            No. of Units                                            Clean/Mortgaged with




                                                                  MANPOWER COMPLEMENT
Total no of
                                                                         Regular                                 Contractual
Employees

      Unionized
                                  Yes                             No                 Name of Union group
                                                                       BUSINESS REFERENCE
                                                                                 DEPOSITORY BANK
    Name of Bank/Branch                   Type of Account           Account Number                    Contact Person                            Telephone/Fax Number




                                                                                       CREDITORS
                 Financial Institution                            Type of Facility                    Contact Person                            Telephone/Fax Number
                                                         T R A D E S U P P L I E R S (minimum of 5 major suppliers)
       Suppliers Name                   Credit Terms            Items Purchased                 Contact person                           Address/Tel./Fax Number




                                                            CLIENTS/CUSTOMERS (minimum of 5 major clients)
      Customer's Name                     Products                 Credit Terms                 Contact person                           Address/Tel./Fax Number




                                                               PERSONAL INFORMATION
Full Name (First, Middle Name, Last)
Birthday (mm/dd/yy)                                           Birthplace                                 Sex                       MALE                     FEMALE
Civil Status                  SINGLE                          MARRIED                 SEPARATED                WIDOW/ER # of Dependents           Religion


      Education                                             Name of School                                             Date Graduated             Citizenship


    High School                                                                                                                                   TIN No.


    College                                                                                                                                       Res. Cert. No. Date Place
    Post Graduate
    Other Course/                                                                                                                                 Home Phone(s)
    Training
                                                                                                                                                  Cellphone No.
    Home Address
                                                                              Yrs. There
Home Ownership                OWNED,MORTGAGED                                         OWNED,NOT MORTGAGE                                          Email Address
                              Mortgage with                                           LIVING W/ RELATIVE
                              RENTED
Do you own a car              Yes                             No
                                              Make                                                                                    Model




                                                                           S P O U S E'S D A T A
Full Name (First, Middle Name, Last)
                                                                                                                                      Nick Name
Birthday (mm/dd/yy)
Employer/Business Name                                                                                                             Occupation
Complete Address                                                                                                                   Phone(s)
                                                                                                                                   Fax
                                                     EMPLOYMENT AND FINANCIAL DATA
Employer/Business Name                                                                                                     Date Employed
Complete Address                                                                                                           Occupation
                                                                                                                           Phone(s)
                                                                                                                           Fax
                                                                                                                           Email Address
Gross Monthly Income                                                          Do you have other credit accomodation? If yes, please list them down.
Applicant                                                                      Include credit cards, if any, and your spouse's obligations
                                                                                  Creditor/Credit Card    Credit Amout/            Monthly             Unpaid Balance
Spouse                                                                                                         Limit             Amortization
Other Sources



Total Monthly Income                                                          Do you require a credit card?                        Yes                      No
                                                                   BANK R E F E RE N C E
                                                                             DEPOSITORY BANK
    Name of Bank/Branch                Type of Account                     Account Number                              Contact Person             Telephone/Fax Number




                                                                     DOCUMENTARY REQUIREMENTS
                                                                      DOCUMENTARY REQUIREMENTS

         a) ITR with Audited Financial Statements (BIR validated) for the past three (3) years
         b) In-House Financial Statements for the past three (3) years, if applicable
         c) Interim Financial Statements, if applicable
         d) SEC Registration with updated General Information Sheet, Articles of Incorporation and By-Laws
         e) Mayor's/Business Permit
         f) DTI Registration
         g) Company Profile
         h) Bank Statements for the past twelve (12) months for both SAVINGS & CURRENT ACCOUNT (active)
         i) Bio-data of Principal (Major Stockholders) Key Officers
         j) Statement of Assets and Liabilities of Major Stockholders
         k) Valid primary ID (eg. Drivers License, SSS,TIN, Passport)


  I hereby certify that above information are true and correct. I also authorize ALGO leasing and Finance, Inc. to use above information to obtain any credit
  verification in relation to my leasing/loan application. This application form may likewise be used for other products and services offered by ALGO Leasing
  and its affiliates.




                                                                                                                 APPLICANT/DATE
                                                                                                            Signature over printed name
10.16.09/kcmh




                                                      AUTHORIZATION / WAIVER FORM



          Gentlemen:

          This is to authorize ALGO LEASING & FINANCE, INC. to conduct investigation on the following:


          A. Credit Cards
                                                 Bank                                        Credit Card No.
                          1
                          2
                          3
                          4
                          5


          B. Bank Accounts
                         Bank                                            Branch                            Type / Account No.
                 1
                 2
                 3
                 4
                 5


          C. Bureau of Internal Revenue (ITR)
                               Taxpayer's Name                                                       TIN
                    1
                    2
                    3
            4
            5


D. Registry of Deeds
                           TCT No.                            Location
            1
            2
            3
            4
            5


E. Others
    1
    2
    3
    4
    5



I / We hereby waive the confidentiality of all information and documents given in favor of ALGO
Leasing & Finance, Inc. In relation to this, I / We hereby hold ALGO Leasing & Finance, Inc., private
company(ies) and government entity(ies) harmless against any action and/or claims of whatever nature
from conducting such investigation, inquiries and checkings.




                Signature over printed name              Signature over printed name
Date Place