AUTOLOAN E-APPLICATION FORM
BORJ BORLAGDAN - NISSAN PASIG CITY
Nissan Model
*
TERRA 2.5L 4X2 EL MT
TERRA 2.5L 4X2 EL AT
TERRA 2.5L 4X2 VE AT
TERRA 2.5L 4X2 VL AT
TERRA 2.5L 4X4 VL AT
NAVARRA 2.5L 4X2 BASE 6MT
NAVARRA 2.5L 4X2 CALIBERE 6MT
NAVARRA 2.5L 4X2 EL CALIBERE 6MT
NAVARRA 2.5L 4X2 EL CALIBERE 7AT
NAVARRA 2.5L 4X4 EL 6MT
NAVARRA 2.5L 4X4 VL 6MT
NAVARRA 2.5L 4X4 VL 7AT
NAVARRA 2.5L 4X2 SV 6MT
NAVARRA 2.5L 4X2 SV 6MT
NAVARRA 2.5L 4X4 SV 7AT
URVAN 2.5L CRDi 18STR MT
URVAN 2.5L CRDi 15STR MT
URVAN 2.5L CRDi 12STR MT
URVAN 2.5L CRDi PREMIUM MT
URVAN 2.5L CRDi PREMIUM AT
URVAN 2.5L CRDi CARGO 3STR MT
URVAN 2.5L CRDi PREMIUM S MT
URVAN 2.5L CRDi PREMIUM S AT
ALMERA 1.2L BASE MT
ALMERA 1.5L E MT
ALMERA 1.5L E AT
ALMERA 1.5L V MT
ALMERA 1.5L VL AT
SYLPHY 1.6L MT
SYLPHY 1.6L CVT
SYLPHY 1.8L CVT
JUKE 1.6L CVT STANDARD
JUKE 1.6L CVT N-STYLE
X-TRAIL 2.0L CVT 4X2
X-TRAIL 2.5L CVT 4X4
PATROL SUPER SAFARI 3.0L CRDi
PATROL ROYALE 5.6L
GT - R PREMIUM
GT - R NISMO
DOWN PAYMENT
*
20%
30%
40%
50%
No. Of YEARS TO PAY
*
5yrs
4yrs
3yrs
2yrs
1yr
PERSONAL INFORMATIONS
PRINCIPAL FULL NAME
*
First Name
Middle Name
Last Name
Suffix
Date of birth (MM/DD/YYYY)
*
Marital Status
*
Single
Married
Widowed
Legally Separated
Not Legally Separated
Cohabitation
Mobile Number 1
*
-
Area Code
Phone Number
Mobile Number 2 (if applicable)
-
Area Code
Phone Number
Phone Number (if applicable)
-
Area Code
Phone Number
Email Address
Ex.nissan@example.com
TIN NUMBER
Present Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
No. Of years in Present Address
*
Ownership of Present Add.
*
Owned
Rented
Mortgage
Living in relatives
Do you have parking lot
*
Yes
No
Do you have Car/s? Select your option
*
Yes(owned as second hand)
Yes (mortgage with bank)
None
SUBMIT
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EMPLOYMENT / BUS. INFORMATIONS
Employer Name / Business Name
*
Employer Complete Add. / Business Complete Add.
*
Job Title / Profession if Self Employed
*
Years in employment / Business
*
Phone Number
*
-
Area Code
Phone Number
Gross Monthly Income
*
Bank Depository / Branch of Account / Type of Account
*
Ex. BPI - TAYTAY / Savings Account
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Co-Maker FULL NAME (Mandatory for Married Principal Applicant)
First Name
Middle Name
Last Name
Suffix
Date of birth (MM/DD/YYYY)
Marital Status
Single
Married
Legally Separated
Not Legally Separated
Cohabitation
Widowed
Mobile Number 1
-
Area Code
Phone Number
Present Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
No. Of years in Present Address
EMPLOYMENT / BUS. INFORMATIONS
Employer Name / Business Name
Employer Complete Add. / Business Complete Add.
Job Title / Profession if Self Employed
Years in employment / Business
Phone Number
-
Area Code
Phone Number
Gross Monthly Income
Bank Depository / Branch of Account / Type of Account
Ex. BPI - TAYTAY / Savings Account
Should be Empty: