Co Signer Statement

CO-SIGNER’S STATEMENT
Makati City, Philippines Date _____________________
I am agreeable to sign with the applicant _______________________________________________ covering P/N

bond/Bond applied for by him from your company in the amount of P ______________________ in favor of
______________________________________________________. I am aware of the responsibility which I will assume
in signing with ____________________________________________________________. I am aware that you will rely
on the truth of the following statement in consideration thereof.
I authorized you obtain such information as you may require concerning the statements made hereunder and agree
that this document shall remain your property whether or not the bond is granted.
______________________________________________________________________________________________
*ALL THE FOLLOWING QUESTIONS MUST BE ANSWERED – IF NONE, NOTE “NONE”*
Name _________________________________ Community Tax Cert. __________________ issued at ______________
On _________________ ACR __________________ _________________ ______________
Business Address ________________________________________________________ Tel No. __________________
Residence Address _________________________________________________________________________________
Salaries, Wages per year P _________________________________ Income from business P ______________________
Amount per year P _______________________________________ Married/Single _____________________________
Living with husband or wife ________________________________ Number of dependents ______________________
If employed please rate: If in business for self, please rate:
Name of Employer _______________________________________ Firm or Trade Name ________________________
Address ________________________________________________ Address __________________________________
Tel Nos. ________________________________________________ Tel Nos. __________________________________
No. of years with employer _________________________________ Kind of business ___________________________
Kind of business of employer _______________________________ How long __________ Capital Invested _________
Position occupied by co-maker ______________________________ _____________Sole Owner or partner _________
Name & Title of superior ___________________________________ Trade references ___________________________
________________________________________________________ Address _________________________________
________________________________________________________ How long ________________________________
Bank Account – Where Kept:
Current _________________________________________________ Savings __________________________________

Real Estate Owned – PLEASE SUBMIT XEROX COPY OF TCTS (FRONT & BACK PAGE)
Title Date Location Area of Assessed Value Encumbrance
No. Acquired Land Land Improvements Amount/Held By
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
____________________________________________________________________________________________
Life Insurance Co. __________________________________________ Amount P _____________________________
Co-signer will state whether applicant is related to him and if so in what manner ________________________________
How long he has known _______________________________ Co-signer will state whether he has ever been a borrower
or co-maker on a personal note at any bank ______________________________________________________________
Name of references __________________________________________ Address _______________________________
_________________________________________ Address _______________________________
I affirm and certify that the foregoing representations are true, correct and accurate.
NOTE: PLEASE SUBMIT THIS WITH YOUR
LATEST INCOME TAX RETURN _______________________________

Signature of Co-signer
SUBSCRIBED AND SWORN TO BEFORE ME this ______day of _______, affiant exhibiting to me his/her Community
Tax Cert No. ________________________ issued at ___________________ on ________________________.
Doc. No. __________ Page No. ________
Book No. _________ Series of 20 ______ NOTARY PUBLIC

Co Signer Statement

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CO-SIGNER’S STATEMENT

Makati City, Philippines Date _____________________

I am agreeable to sign with the applicant _______________________________________________ covering P/N

*ALL THE FOLLOWING QUESTIONS MUST BE ANSWERED – IF NONE, NOTE “NONE”*

Name _________________________________ Community Tax Cert. __________________ issued at ______________

On _________________ ACR __________________ _________________ ______________

Business Address ________________________________________________________ Tel No. __________________

Residence Address _________________________________________________________________________________

Salaries, Wages per year P _________________________________ Income from business P ______________________

Amount per year P _______________________________________ Married/Single _____________________________

Living with husband or wife ________________________________ Number of dependents ______________________

If employed please rate: If in business for self, please rate:

Name of Employer _______________________________________ Firm or Trade Name ________________________

Address ________________________________________________ Address __________________________________

Tel Nos. ________________________________________________ Tel Nos. __________________________________

No. of years with employer _________________________________ Kind of business ___________________________

Position occupied by co-maker ______________________________ _____________Sole Owner or partner _________

Name & Title of superior ___________________________________ Trade references ___________________________

________________________________________________________ Address _________________________________

________________________________________________________ How long ________________________________

Bank Account – Where Kept:

Current _________________________________________________ Savings __________________________________

Title Date Location Area of Assessed Value Encumbrance

No. Acquired Land Land Improvements Amount/Held By

Life Insurance Co. __________________________________________ Amount P _____________________________

Name of references __________________________________________ Address _______________________________

_________________________________________ Address _______________________________

NOTE: PLEASE SUBMIT THIS WITH YOUR

LATEST INCOME TAX RETURN _______________________________

Doc. No. __________ Page No. ________

Book No. _________ Series of 20 ______ NOTARY PUBLIC

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ALL THE FOLLOWING QUESTIONS MUST BE ANSWERED – IF NONE, NOTE “NONE”

Name _________________ Community Tax Cert. issued at

On _______ ACR _ ______

Business Address ______________________________________ Tel No.

Salaries, Wages per year P ___________ Income from business P

Amount per year P ___________ Married/Single _

Living with husband or wife __________ Number of dependents

Name of Employer _______________ Firm or Trade Name

Address ______________ Address

Tel Nos. ______________ Tel Nos.

No. of years with employer _______ Kind of business _

Position occupied by co-maker ________________________ _Sole Owner or partner ___

Name & Title of superior _________ Trade references _

________________________ Address _

________________________ How long

Current _______________ Savings

Life Insurance Co. ______________ Amount P _

Name of references ____________ Address _

___________ Address _

Doc. No. __ Page No.

Book No. ___ Series of 20 NOTARY PUBLIC