RURAL BANK OF LANUZA, INC.

Bo. Puyat, Carmen, Surigao del Sur

APPRAISAL REPORT
APPLICANT:__________________________
AGE:____
OCCUPATION:_______________
SPOUSE :____________________________
AGE:____
OCCUPATION:_______________
RESIDENCE:__________________________________________________________________________________
REAL ESTATE COLLATERAL
1.
Commercial/Residential/Industrial/Agricultural Land.
OCT/TCT No._______________________________
TD No.________________________________
Registered Owner: ______________________________________________________________________________
Owner's Address:_______________________________________________________________________________
Date Registered:_____________________________
Lot & Block No.__________________________
Location:______________________________________________________________________________________
Average Depth:______________________________
Average Width:___________________________
Frontage:___________________________________
Surfacing of Street:________________________
Type of Terrain:_________________________________________________________________________________
______________________________________________________________________________________________
Kind/Width of Sidewalk:___________________________________________________________________________
______________________________________________________________________________________________
Encumbrance/Annotation:_________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
Boundaries:____________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
Location/Description:_____________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
Accessibility/Landmarks:__________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
Marketability:___________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
Area (hectares or square meters)
Value (per hectare or square meter)
Market Value
Appraisal Factor
Appraised Value (A)

________________
P ______________
P_______________
________________
P_______________

2.
Improvements on Land.
Nature: _____________________________________Type:__________________________________________
Erected on Lot/Block No._______________________Roofing:________________________________________
When Constructed:____________________________When Remodelled:_______________________________
Make of Surrounding
Building:_____________________________________________________________________________
Type of Neighborhood:__________________________Painting Condition:________________________________
Area of Ground and Other
Floors:___________________________________________________________________________
Others
(Specify):_______________________________________________________________________________________
_______________________________________________________________________________________________
Materials
Used:__________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Compartments/Rooms:_____________________________________________________________________________

_______________________________________________________________________________________________
_______
_______________________________________________________________________________________________
Facilities:________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Area of Ground and Other Floors (sq. meters)
Reproduction Cost/area
Reproduction Cost
Estimated Useful Life
Annual Depreciation
No. of Years Existing/Used
Total Depreciation
Present Market Value
Appraisal Factor
Net Appraised Value (B)
3.

__________________
P_________________
P_________________
__________________
P_________________
__________________
P_________________
P_________________
__________________
__________________

Appraised Value of Land and Improvements (A+B)

Multiply by Loan Value Factor

P_____________
______________

TOTAL LOAN VALUE OF LAND AND IMPROVEMENTS

P_____________

_________________________
Date of Actual Inspection
Prepared:_________________

_______________________________
Name and Signature of AppraiserDate

Collateral Inspection and Appraisal authorized by:

_________________________
Manager/Loan Officer
_______________________________________________________________________________________________
Note: If collateral consists of several parcels of land or building improvements on a parcel of land, use another
appraisal report sheet.

RURAL BANK OF LANUZA, INC.

Bo. Puyat, Camen, Surigao del Sur
APPLICATION FORM (For New Applicant)
APPLICANT:________________________ AGE:____
SPOUSE:___________________________ AGE:____
RESIDENCE:______________________________________
BUSINESS ADDRESS:______________________________
I.

PURPOSE OF THE LOAN APPLIED FOR:

Specific Purpose
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
II.

Amount
___________________
___________________
___________________
___________________
___________________
___________________

EXPENSES
AMOUNT
________________________ ______________
________________________ ______________
________________________ ______________
________________________ ______________

ADDRESS
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________

AMOUNT
________________
________________
________________
________________
________________

REMARKS
_____________
_____________
_____________
_____________
_____________

MANNER OF REPAYMENT:
Daily (___)
Weekly(___)
Quincena(___)

V.

AMOUNT
__________
__________
__________
__________

OUTSTANDING OBLIGATIONS:

CREDITORS
___________________
___________________
___________________
___________________
___________________
IV.

Date Needed
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________

YEARLY INCOME AND EXPENSES:

SOURCES OF INCOME
___________________________________
___________________________________
___________________________________
___________________________________
III.

OCCUPATION:_______________________
OCCUPATION:_______________________
NO. OF DEPENDENTS:________________
Elem.___
H.S.___ Col.____

Monthly(___)
Every 3 Mos.(___)
Other Manner:
Every 2 Mos.(___)
Semi-Monthly(___)
Quarterly(___) Annual(___)

____________________
____________________
____________________

CREDIT REFERENCES:

Bank & Other Creditors

______________________
______________________
______________________
______________________
______________________

Type of Deposit
_____________
_____________
_____________
_____________
_____________

Nature of Credit Extended

_____________________
_____________________
_____________________
_____________________
_____________________

VI. COLLATERALS OFFERED:

DESCRIPTION

MARKET VALUE

____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________

VII.

INSURANCE COVERAGE ON COLLATERAL OFFERED:

ITEM COVERED
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________

AMOUNT
________
________
________
________
________
________

INSURANCE COMPANY
_____________________
_____________________
_____________________
_____________________
_____________________
_____________________

I, We hereby certify that all information herein and herewith furnished are in all respects true and correct and
I/we further agree that this document shall remain the property of the bank whether my/our credit request is granted
or not.
I/We authorize the bank to obtain other information as may be required in connection with this request and
I/we are aware that to use the proceeds of this loan for purpose other than those indicated herein is unlawful.
I/we hereby agree to make an advance payment of P____________to cover the cost of transportation and
other incidental expenses which shall be incurred in processing my/our loan application. Further, I/we agree to make
additional payments in case the advance is not sufficient to cover the cost of expenses incurred.

__________
Date

___________________________
Name/Signature of Applicant

________________________
Name/Signature of Spouse