VICENTE D.

TRINIDAD NATIONAL HIGH SCHOOL To be filled up by the CREDIT COMMITTEE

COOPERATIVE
Ajat, Iguig, Cagayan Verified by: ____________________________________
Application Received by: _________________________
LOAN APPLICATION/AGREEMENT Date Received: _________________________________
(Fill up the form in 2 copies) We recommend a loan of Php _____________ be granted for a period of
________________ months
I hereby apply for a commodity loan in the amount of PESOS Name of Borrower: _____________________________
____________________________________________________________ Date of Booking: ______________________________
(Php______________________) payable within____________months, which I
promise to pay in accordance to the rules and regulations of VICENTE D. Verified and Approved by:
TRINIDAD NATIONAL HIGH SCHOOL COOPERATIVE and the terms and
conditions as stipulated in the covering Promissory Note that have been fully LEILANIE MATIAS LEONYMAR ZALUN
disclosed and explained to me and which I certify to have understood clearly Chairman-Credit Committee Co-Chairman-Credit Committee

Released by:
Name of Borrower: ___________________________________________ IMELDA M. TATTAO
Age: _______________________________________________________ VDTNHS-Coop. Treasurer
Employee Number : __________________________________________
Designation: ________________________________________________
LOAN AMOUNT NET PROCEEDS MONTHLY AMORTIZATION
Present Address: _____________________________________________
5 Months
Civil Status: __________________ Gender: ___________________
7500 7400 1545.00
Date of Birth: _______________________________________________
CP Number : ________________________________________________ 7000 6900 1442.00
6500 6400 1339.00
I certify that the information I provided above is true and correct. 6000 5900 1236.00
5500 5400 1133.00
______________________________________ 5000 4900 1030.00
Signature over Printed Name 4500 4400 927.00
4000 3900 824.00
NOTE: There will be a penalty of 50 pesos/month in case of late payment. 3500 3400 721.00

Service Fee: Php 50.00 Share Capital: Php 50.00

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