VIP LOGIN
BRANCH LOCATOR
Application Form
APPLICATION INFO
Area/Branch:
Select Area
Cavite
Laguna
Batangas
Mindoro
Rizal
Metro Manila
Marinduque
Quezon
Davao
North Luzon
Select Branch
Motorcentral Calapan
Mode of Payment :
Select Type
Cash
Installment
Are You A Previous Customer?:
Select Type
Yes (Cash)
Yes (Installment)
No
Brand/Model:
Select Brand
Honda
Kawasaki
Suzuki
Yamaha
BAJAJ RE
Kymco
Select Model
Down Payment:
Monthly Installment:
Term:
Select Terms
3 months
6 months
12 months
18 months
24 months
30 months
36 months
48 months
60 months
Color:
CUSTOMER'S INFO
Name:
Date of Birth:
Gender:
Select Gender
Male
Female
Marital Status:
Select Marital Status
Single
Married
Widowed
Separated
Divorced
Live-In
Age:
Number of Dependents (to include child and other relative/s living with the applicant)*
Name
Relationship
Age
School
School Address
Contact / Telephone Numbers:
Internet Based Contact:
ADDRESS INFO
Present Home Address
Status of Residency:
Select Status of Residency
Mortgaged
Not Morgaged
Living with parents
Living with relatives
Company-provided border
Bed Spacer / Border
Renter
Others
Length of Stay:
Year(s):
Month(s):
Previous Address (if less than 2 years in present address)
Provincial Address
Same as Home Address
EMPLOYMENT INFORMATION / PRINCIPAL APPLICANT
Type of Borrower:
Select Type of Borrower
Employed
Self-Employed
Recipient of Remmitance
Agri-Fishery Based
Pensioner
OFW
Name of Present Employer:
Nature of Business of Company:
Select Nature of Business
Government Employee (military/court/government hospital/LGU)
Private Firm (hospital/accounting/law/construction/real estate/fast food-restaurants/schools-colleges-universities)
Manufacturing (electronics/motorized vehicle/apparels/pharmaceutical/food&beverages)
Banking/Financing/Lending Institutions
BPO/Call Center
Wholesale/Retail Store Employee (mall shop/grocery store/car & motorcycle shops/book stores)
Logistics & Delivery Services (lazada/lalamove/redninja etc.)
Hired Farm Worker and Fisherman
Others please specify
Private & Public Transport Operator (bus/van/puj/taxi/tricycle/boat)
Canteen/Restaurant/Catering Services Operator
Rental Business (commercial & residential building/private resorts)
Retail Business (sari-sari & grocery store/online selling/repair shops/sallon-spa/barber shop)
Private Practicioner (medical/dental/veterinary doctors/accountant/lawyer/engineers)
AGRICULTURE Based (rice-vegetable farming/fishing/cattle-hog-goat raising/poultry)
Others please specify
OFW
SEAMAN
LOCALLY EMPLOYED
PENSIONER
Others please specify
Employer / Business Address:
Contact No:
Years Employed:
Employment Status:
Select Employment Status
Regular / Permanent
Probationary
Contractual/ Project Hire / Consultant
Fixed Term
Recepient of Remittance
Pensioner
Self- employed / Freelance
Others (please specify)
Position:
Previous Employer (if applicable)
Name of Previous Employer / Business:
Nature of Business:
Select Nature of Business
Government Employee (military/court/government hospital/LGU)
Private Firm (hospital/accounting/law/construction/real estate/fast food-restaurants/schools-colleges-universities)
Manufacturing (electronics/motorized vehicle/apparels/pharmaceutical/food&beverages)
Banking/Financing/Lending Institutions
BPO/Call Center
Wholesale/Retail Store Employee (mall shop/grocery store/car & motorcycle shops/book stores)
Logistics & Delivery Services (lazada/lalamove/redninja etc.)
Hired Farm Worker and Fisherman
Others please specify
Private & Public Transport Operator (bus/van/puj/taxi/tricycle/boat)
Canteen/Restaurant/Catering Services Operator
Rental Business (commercial & residential building/private resorts)
Retail Business (sari-sari & grocery store/online selling/repair shops/sallon-spa/barber shop)
Private Practicioner (medical/dental/veterinary doctors/accountant/lawyer/engineers)
AGRICULTURE Based (rice-vegetable farming/fishing/cattle-hog-goat raising/poultry)
Others please specify
OFW
SEAMAN
LOCALLY EMPLOYED
PENSIONER
Others please specify
Contact No:
Employment Status:
Select Employment Status
Regular / Permanent
Probationary
Contractual/ Project Hire / Consultant
Fixed Term
Recepient of Remittance
Pensioner
Self- employed / Freelance
Others (please specify)
Employer / Business Address:
Position:
Years connected:
MONTHLY INCOME DETAILS
Salary
Business Income
Other Income
GROSS INCOME
SPOUSE'S INFO (if ANY)
Name:
Date of Birth:
Contact / Telephone Numbers:
Present Home Address
Same as Princial Home Address
Length of Stay:
Year(s)
Month(s)
EMPLOYMENT INFO of SPOUSE (if ANY)
Name of Present Employer / Business:
Nature of Business:
Select Nature of Business
Government Employee (military/court/government hospital/LGU)
Private Firm (hospital/accounting/law/construction/real estate/fast food-restaurants/schools-colleges-universities)
Manufacturing (electronics/motorized vehicle/apparels/pharmaceutical/food&beverages)
Banking/Financing/Lending Institutions
BPO/Call Center
Wholesale/Retail Store Employee (mall shop/grocery store/car & motorcycle shops/book stores)
Logistics & Delivery Services (lazada/lalamove/redninja etc.)
Hired Farm Worker and Fisherman
Others please specify
Private & Public Transport Operator (bus/van/puj/taxi/tricycle/boat)
Canteen/Restaurant/Catering Services Operator
Rental Business (commercial & residential building/private resorts)
Retail Business (sari-sari & grocery store/online selling/repair shops/sallon-spa/barber shop)
Private Practicioner (medical/dental/veterinary doctors/accountant/lawyer/engineers)
AGRICULTURE Based (rice-vegetable farming/fishing/cattle-hog-goat raising/poultry)
Others please specify
OFW
SEAMAN
LOCALLY EMPLOYED
PENSIONER
Others please specify
Contact No.:
Employment Status, if employed:
Select Employment Status
Regular / Permanent
Probationary
Contractual/ Project Hire / Consultant
Fixed Term
Recepient of Remittance
Pensioner
Self- employed / Freelance
Others (please specify)
Employer / Business Address:
Position:
Years connected:
Gross Income (monthly):
CO-MAKER INFO (if ANY)
Name:
Date of Birth:
Contact / Telephone Numbers:
Present Home Address
Length of Stay:
Year(s)
Month(s)
CO-MAKER EMPLOYMENT (if ANY)
Name of Present Employer / Business:
Nature of Business:
Select Nature of Business
Government Employee (military/court/government hospital/LGU)
Private Firm (hospital/accounting/law/construction/real estate/fast food-restaurants/schools-colleges-universities)
Manufacturing (electronics/motorized vehicle/apparels/pharmaceutical/food&beverages)
Banking/Financing/Lending Institutions
BPO/Call Center
Wholesale/Retail Store Employee (mall shop/grocery store/car & motorcycle shops/book stores)
Logistics & Delivery Services (lazada/lalamove/redninja etc.)
Hired Farm Worker and Fisherman
Others please specify
Private & Public Transport Operator (bus/van/puj/taxi/tricycle/boat)
Canteen/Restaurant/Catering Services Operator
Rental Business (commercial & residential building/private resorts)
Retail Business (sari-sari & grocery store/online selling/repair shops/sallon-spa/barber shop)
Private Practicioner (medical/dental/veterinary doctors/accountant/lawyer/engineers)
AGRICULTURE Based (rice-vegetable farming/fishing/cattle-hog-goat raising/poultry)
Others please specify
OFW
SEAMAN
LOCALLY EMPLOYED
PENSIONER
Others please specify
Contact No.:
Employment Status, if employed:
Select Employment Status
Regular / Permanent
Probationary
Contractual/ Project Hire / Consultant
Fixed Term
Recepient of Remittance
Pensioner
Self- employed / Freelance
Others (please specify)
Employer / Business Address:
Position:
Years connected:
LOAN REFERENCE/S (if ANY):
bank/lending/financial institution
type of loan
loan amount
monthly installment
term
date granted
maturity date
PERSONAL REFERENCE/S (other than living with the BORROWER or CO-MAKER):
name
relationship
address
contact details
REQUIREMENTS
2 valid government issued Ids (SSS ID, Police Clearance, NBI Clearance, Postal ID, Passport, Driver’s License, Pag-Ibig ID, PRC ID, UMID ID)
Latest one (1) month Payslip indicated your salary
Billing statement named after applicant whenever applicable
SKETCH MAP (from our store/branch to your residence and indicate major LANDMARKS as reference like schools, commercial building, government/private offices, barangay halls and others):
In compliance with the Data Privacy Act (DPA) of 2012 and its Implementing Rules and Regulations (IRR), I allow the Motorcentral Group of Companies, its subsidiaries, affiliates, and other authorized representatives to collect, transfer, share, retail and use my personal information for sales and marketing purposes.
I accept and agree to the
Privacy Statement.
SUBMIT APPLICATION