BOHOL COMMUNITY MULTI-PURPOSE COOPERATIVE

Loan Application Form

Instruction: Fill out the application clearly and legibly

Applicant

Loan Applied For *

Name of Applicant *

Tel No.

Date of Birth *

Address *

Occupation *

Age *

Gender *

Status *

Tin *

Business Address*

Monthly Income *

Wife/Husband

Wife/Husband Name

Tel No.

Date of Birth

Address

Occupation

Age

Gender

Status

Tin

Business Address

Monthly Income

Members Income and Expenses

Monthly Income:

Salary *

Business *

Profession *

Monthly Pension *

Monthly Commission *

Investment Income *

Spouse Income *

Total Income *

Monthly Expenses

Basic Family Expenses

Food Expenses *

Education *

Utilities (Elec,Bill,Water Bill, etc) *

Transportation *

Financial Expenses

BCMPC Loan Payments *

Bank Loan Payments *

Finance Co. Payments *

Credit Card Payments *

Other Debt Payments *

Other Expenses

Housing *

Vehicle Fuel/Maint *

Other Expenses *

Assigned to Spouse *

Total Expenses *

Net Income/Savings *