288897
288897
288897
Present residential address (Building no. | Block | Street | Building | Subdivision/Village | Barangay | Province/City | Municipality) ZIP Code Occupied since (Year)
Gender Civil status Spouse’s last name First name Middle name Suffix
Principal office address (Building no. | Block | Street | Building | Subdivision/Village | Barangay | Province/City | Municipality) ZIP Code Occupied since (Year)
Average monthly gross sales Average monthly cost of sales Average monthly gross income Other sources of funds Income from other business/es (If any)
AUTHORITY OF UNDERTAKING
Major suppliers’ business name Major suppliers’ contact person Major suppliers’ contact number
Major clients’ business name Major clients’ contact person Major clients’ contact number
Main/Primary bank name Bank branch Account number Account name Year opened
As the loan applicant, you affirm that all information provided in this application form are true and correct, and all supporting documents submitted directly to Esquire Financing Inc. (referred to as “EFI”) or its official sales
channels are legitimate, genuine and legally obtained from the issuing government agencies/private entities. Any incorrect or misleading information and misrepresentation will result to disapproval of the application. In case of
disapproval, EFI is under no obligation to disclose the reason/s for such disapproval. In furtherance of your application, you hereby give consent to the following circumstances: (1) Entrance and inspection of your residence,
main/principal place of business and operations facility/ies by duly authorized representatives of EFI as part of its credit evaluation and in order to validate all the information disclosed by you in this Application Form and in any
supporting documents submitted by you to EFI; (2)Verification of any information provided herein and in any supporting documents hereto with any applicable banks, credit bureaus, private or government agencies and other
institutions, as may be indicated in this application form, or with any entities/individuals you have additionally indicated in this application form; (3) Release or disclosure of any relevant information by such holder, controller,
and processor of the information to confirm, release and verify the existence, truthfulness, and/or accuracy of any information provided to EFI; (4) Processing of your information under the Data Privacy Act of 2012 (R.A. No.
10173) for legitimate and lawful purposes, and disclose any and all information as required by relevant authorities; and (5) Receipt by you from EFI, its affiliates, and third-party vendors or partners of Short Messaging Services
(SMS), mobile and/or email alerts/messages for the purpose of confirming your application and its status. You hereby expressly waive any and all statutory and regulatory provisions governing confidentiality of client information
with respect to any information you entered in this Application Form and in any supporting documents hereto insofar as it is necessary to disclose appropriate information to verify such other information provided in this
Application Form and in any supporting documents hereto. You hereby agree to indemnify and hold EFI, its affiliates, officers, directors, employees, consultants, contractors, agents and representatives free and harmless from
any and all third party claims, losses, liability, damages and costs arising from any liabilities that may arise due to inaccurate representation of any information indicated herein.