Mitsubishi Philippines Loan Application Form
Contact us at (02) 703 3267 / +63 (915) 964 0529

First Name (required)

Middle Name (required)

Last Name (required)

Civil Status (required)

— Single Married Common Law

Sex (required)

— Male Female

Age (required)

Date of Birth (required)

TIN #: (required)

Nationality (required)

Contact Number (required)

Email Address

Present Address (required)

Years of Stay (required)

Work/Business Information

Source of Income
Employed Business 

Monthly Income

Company/Business Name

Position

Length of Service

Employment/Business Address

Company Contact Number

Bank Accounts:

Financial Institution:

— PS Bank Banco De Oro (BDO) Metrobank BPI (Bank of the Philippine Island) BPI Family Savings Bank PNB RCBC Unionbank Chinabank Allied Bank Maybank Landbank Asia United Bank (AUB) Citibank Development Bank of the Philippines (DBP)

Branch

Co-Maker/Spouse Personal Information

First Name

Middle Name

Last Name

Civil Status

— Single Married Common Law

Sex

Age

Date of Birth

TIN #

Nationality

Contact Number

Email Address

Present Address

Years of Stay

Co-Maker/Spouse Work/Business Information

Source of Income
Employed Business 

Monthly Income

Employment/Business Name

Position

Length of Service

Employment/Business Address

Company Contact Number

Co-Maker/Spouse Bank Accounts

Bank Account with

— PS Bank Banco De Oro (BDO) Metrobank BPI (Bank of the Philippine Island) BPI Family Savings Bank PNB RCBC Unionbank Chinabank Allied Bank Maybank Landbank Asia United Bank (AUB) Citibank Development Bank of the Philippines (DBP)

Branch

Vehicle Information

Car Model/Type (required)

— 2014 MIRAGE HB GLX 1.2G MT 2014 MIRAGE HB GLX 1.2G AT 2014 MIRAGE HB GLS 1.2G MT 2014 MIRAGE HB GLS 1.2G AT 2015 MIRAGE HB GLX 1.2G MT 2015 MIRAGE HB GLX 1.2G AT 2015 MIRAGE HB GLS 1.2G MT 2015 MIRAGE HB GLS 1.2G AT 2014 MIRAGE G4 GLX 1.2G MT 2014 MIRAGE G4 GLX 1.2G AT 2014 MIRAGE G4 GLS 1.2G MT 2014 MIRAGE G4 GLS 1.2G AT 2014 MONTERO SPORT GLX 2.5D 4X2 MT Non-VGT 2014 MONTERO SPORT GLX 2.5D 4X2 AT Non-VGT 2014 MONTERO SPORT GLS V 2.5D 4X2 AT 2014 MONTERO SPORT GLS V 2.5D 4X4 MT 2014 MONTERO SPORT GT V 2.5D 4X4 AT 2014 MONTERO SPORT GLS 3.0G 4X2 AT 2014 LANCER EX GLX 1.6G MT 2014 LANCER EX GLX 1.6G AT 2014 LANCER EX MX 1.6G AT 2014 LANCER EX GTA 2.0G CVT 2014 ADVENTURE TX 2.5D MT 2014 ADVENTURE GX 2.5D MT 2014 ADVENTURE GLX Sport 2.5D MT 2014 ADVENTURE GLS Sport 2.5D MT 2014 ADVENTURE Super Sport 2.5D MT 2014 STRADA GL 2.5D 4X2 MT 2014 STRADA GLX2.5D 4X2 MT 2014 STRADA GLX V 2.5D 4X2 AT 2014 STRADA GLX 2.5D 4X4 MT 2014 STRADA GLS V 2.5D 4X4 MT 2014 STRADA GLS Sport V 2.5D 4X4 AT 2014 PAJERO 3.8 Gas 2014 PAJERO 3.2 DSL 2014 ASX GLS 2.0 4X2 AT 2014 ASX GLS SE 2.0 4X4 AT 2014 FUZION GLS Sport 2.4 AT 2014 FUZION GLX 2.4 Gas AT L300 EURO2 Deluxe Chassis Cab L300 EURO2 Deluxe FB Bare L300 EURO2 Deluxe FB Single AC L300 EURO2 Deluxe FB Dual AC L300 EURO2 Exceed Chassis L300 EURO2 Exceed FB Body Bare L300 EURO2 Exceed FB Body Single AC L300 EURO2 Exceed FB Body Dual AC L200 2.5CC 4X2 MT Single CC L200 2.5 GC 4X2 MT Single Cab L200 Fabricated Body L200 Fabricated Body Single AC L200 Fabricated Body Dual AC

Color (required)

Downpayment (required)

— 20% Citimotors All-in Promo 25% 30% 35% 40% 45% 50% 55% 60%

Loan Terms (in years) (required)

— 5 years 4 years 3 years 2 years 1 year