Information Sheet

SEC information sheet for lending company branch office

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INFORMATION SHEET OF THE PROPOSED



I.




BRANCH
SATELLITE

EXTENSION
UNIT

Corporate Profile:
1. Name of Corporation

:

2. Date of Incorporation

:

3. Certificate of Authority No./
Date of Approval

:

4. Principal Office Address

:

5. Contact Number

:

6. Officer of Branch1:
Name

:

Address

:

Position

:

Birth date

:

Birth Place

:

T. I. N.

:

Specimen Signature

:

Officer of Branch
Name
Address

:

Position

:

Birth date

:

Birth Place

:

T. I. N.

:

Specimen Signature

1

:

:

Include Branch Manager, Administrative Officer and Cashier. Attach additional sheet if needed.
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LENDING COMPANY – BRANCH OFFICE

Officer of Branch
Name

:

Address

:

Position

:

Birth date

:

Birth Place

:

T. I. N.

:

Specimen Signature

:

7. Capital Structure of Head Office

Class of
Shares

No. of Shares

Par/Stated
Value
(PhP)

Aggregate
Value/Amount
(PhP)

Authorized Capital
Stock
Subscribed Capital
Stock
Paid-up Capital

8. Directors and Officers
Name

Citizenship

Residence

Position

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LENDING COMPANY – BRANCH OFFICE

9. Assigned Capital of the Branch

P

10. Address of the Proposed Branch

11. Branch’s credit and collection policies*

Type of Loan

Minimum/Maximum
Loan Value
(PhP)

Rate of
Interest

Term of Loan

Mode of
Payment

12. Other Branches with Certificates of Authority (CA)*

CA No.

Address

Classification

Assigned
Capital

* Attach additional sheet if needed.
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LENDING COMPANY – BRANCH OFFICE

13. Existing Lending Companies in the Area
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

14. Sources of Income in the Locality
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

I hereby certify that all information set forth in the above report is true and correct to the best of my
knowledge and belief.

Signature of the President over Printed Name

REPUBLIC OF THE PHILIPPINES)
IN THE CITY OF
) S.S.
SUBSCRIBED AND SWORN TO before me this ____ day of ______________, _____ the
above affiant exhibiting to me his/her Tax Identification Number ___________ issued at
____________________ on ____________________.

NOTARY PUBLIC

Doc. No. __________
Page No. __________
Book No. __________
Series of __________
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