MagCoop Loan Application

Loan Application Form

Client Type

Magsaysay ID Number

Magsaysay ID Validity

First Name

Middle Name

Please input 'N/A' if none.

Last Name

Date of Membership

Email Address

Address

City / Province

Date Of Birth

Telephone Number

Mobile Number

Gender

Civil Status

No. of Children

Name of Spouse

Living Status

Date Hired

Company / Fleet

Position Level

Position

Magsaysay Experience

Please input 0 if less than a year.

Loan Application Details

Type of Loan

Loan Amount

Term

Manner of Loan Payment

To be deducted from allotment of:

Crew Allottee

Payroll deduction

Manner of Loan Release (Please provide an active and valid PHILIPPINE bank account. Dollar accounts will NOT be processed.)

Credit Memo Bank Cheque

Loan Requirements

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We hereby agree that MAGCOOP may collect, use, disclose and process my personal information set out in this form and/or otherwise provided by me for one or more of the following purposes: verifying if client is qualified for a loan; verifying the client’s identity; records purposes; documentary purposes; and providing updates on cooperative services, products and events.