Mitsubishi Car Dealership in Makati | New Models | Promo(s)

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Mitsubishi Car Application form

Important Information: Please. fill out all entries in the form to ensure rapid process of your loan application. Incomplete information will cause delay in processing.

Alternative Option: Prefer to fill out a PDF file? Download the PDF Form and send it to

mitsubishimakati@gmail.com

BORROWERS INFORMATION

Vehicle

Selling Price

Down Payment

Amount for Financing

Terms

Name(required)

Email(required)

Mobile Number

Residence Telephone Number

Birth Date

Gender

Female

Male

Residences Address

Residence Status:

Owned – NOT Mortgaged

Owned – Mortgaged

Living with Family

Company Provided

Rented

Length of Stay

Civil Status:

Single

Married

Widowed

Seperated

Common Law Marriage

No. of Dependents

Citizenship

TIN Number

Employer / Business name

Length of Stay

Office Address

Nature of Business

Office Number

Monthly Income

Employment Type

Salary

Self-Employed

OFW

Position

BANK ACCOUNTS

Format: Bankname-Type of Account-Account Number

CO-BORROWERS INFORMATION

Name(required)

Email(required)

Mobile Number(required)

Residence Telephone Number

Birth Date

Relation to Borrower

Gender

Female

Male

Residences Address

Residence Status:

Owned – NOT Mortgaged

Owned – Mortgaged

Living with Family

Rented

Company Provided

Length of Stay

Civil Status:

Married

Widowed

Seperated

Common Law Marriage

Citizenship

No. of Dependents

Employer / Business name

TIN Number

Length of Stay

Office Address

Nature of Business

Employment Type

Single

Salary

Self-Employed

OFW

Office Number

Monthly Income

Position

I hereby authorize CT CITIMOTORS INC. to process and share my personal data to
any of its accredited banks, which is likewise authorized to receive,use ,collect ,
and process my personal data, for the purpose of financing my purchase of auto
vehicle/s from the dealer, or assignment of the dealer’s rights to its accredited bank,
including verification, customer profiling, cross- checking, and credit investigation.

In this regard, my personal information may also be shared with accredited bank’s branches, subsidiaries affiliates, representatives , or third party service providers .

I am also aware that the details of how my personal data will be processed and
the rights available

to me are listed in the accredited bank’s Privacy Policy Statement . If I want to access, update , or correct mypersonal data, or withdraw my consent, I know that I may contact the customer service of CT CITIMOTORS INC.

Borrower's Signature Over Printed Name

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Service: 892 0331 loc. 455 or 456
Parts: 892 0331 loc. 444 or 445

Location: San Lorenzo Village,
Corner Chino Roces Avenue, Don Bosco,
Makati City

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