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Section 2

This document is a co-signer's statement for an insurance application. It provides personal details of the co-signer such as name, address, occupation, income, bank accounts, real estate owned, and relationship to the applicant. It also includes a statement agreeing to co-sign and authorizing verification of the information.

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Robert Fergusto
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0% found this document useful (0 votes)
596 views2 pages

Section 2

This document is a co-signer's statement for an insurance application. It provides personal details of the co-signer such as name, address, occupation, income, bank accounts, real estate owned, and relationship to the applicant. It also includes a statement agreeing to co-sign and authorizing verification of the information.

Uploaded by

Robert Fergusto
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

CO-SIGN|ER'S STATEM ENT

TO: STRONGHOLD IN§URANCE CO., fNC. I


17th Floor securfty Bank centre (
6776 Ayala Avenue, Maketi City

PLEASE PRINT AND/OR TYPE ANSWER:


The ilndersigned hereby agrees to actias co.signer to ARMAND0 E. ASIO
jn the amount of Ps. applied by JPMJ SuBICTRA
Infavor of
NAME: ARMANDJAYV. ASIO F'LIPINO
ADDRESS: (Res.u.OT 19, BLI( 3, SIERRA HILLSSuBD., SU BfuNBAffirfuA::Ty 250-3452
(Office) LOT 29-A EFFICIENCY AVE., SUBIC BAY GATEWAY PARK, Tel. N{i. 250-3452
CML STATUS: SINGLE NAME OF SPOUSE:
OCCUPATION: CORPORATE SECRETARY INCOME: UALLY/MONTHLy PHP 80,000-00

lF EMPLOYED, PLEASE STATE:


NAME OF EMPLOYER: -RADE NAME:

ADDRESS: ADDRESS:
TEL NO. NO,OF YEARS TEL NO. NO. OF YEARS
KIND OF BuSINESS:
.KIND OF BUSINESS:
posmoN OccupiED: CAPITAL INVESTED:
NAME & DESIGNATION OF SuPERI0R: TRADE REFERENCE:

(lF THE SPACE PROVIDED IS NOT ENOUGH, USE BACK HEREOF)


BANKACCOUNTS:
CuRRENT ACCOUNT:
TIME AND/OR SAVINGS DEPOSITS:

REAL ESTATE AND/OR PERSONAL PROPERTI ES OWNED!


DATE AREA
ASSESSED VALUE, lNCuMBRANCE
ACQUIRED LOCATION OF DESCRIPTION 0FLAND
LArdD iMPROvEMENT AMOuNT PAID

LIFE INSURANCE:
AMOUNT
REALTIONSHIPW!THAPPLICANT:_FAT.H.ER_
HOW LONG HAVE YOU KNOWN THE APPLICANT?
HAVE YOU EVER BEEN A BORROWER OR CO-MAKER ON A PROMISSORY NOTE WITH ANY LENDING
INSTITUTION? (PLEASE EXCLUDED RELATIVE)
NAM E 0CCUPATloN ADDRESS

The foregoing statement and representation are true and correct and made for the purpose of
including the STRONGHOLD INSURANCE CO., lNC„ to issue the bond applied for. This w
also-serve as
an author]ty for the said company to verify from the above-mentioned persons, bank entities the
veraclfy of the above Information I have declared.

(slgnotwre) - -`1`-a
SIGNED [N THE PRESENCE OF:

REPUBLIC OF THE PHILIPPINES)

)S,S

SUBSCR]BEB AND SWORN to before me this


_201_atthe
Affiant exhibiting to me his/her Community Tax Certificate No.
issued at

Doc. No.
Page NO.
Book No.
Series of

i
C®-SIGNER'S STATEMENT

TO: STRONGHOLD INSURANCE CO., INC.


17th Floor Security Bank Centre
6776 Ayala Avenue, Makati City

PLEASE PRI NT AND/OR TYPE ANSWER:


The undersigned hereby agrees to act a5 co-slgner to ARMANDO E. ASIO
in theamount of ps. applied dy JPMJ SUBICTRA
In favor of
NAME: MARIVIC V. Aslo
ADDRESS: (Res.ItoT 19, BLK 3, SIERRA HILLS SUBD., sEjBfroNBAife#i`TyEjffi#
LOT Z9-A EFFICIENCY AVE., SuBIC BAY GATEWAY PARK, SBFZ
(Office) Tel. No, 250-3452
CIVILSTATu5: MARRIE NAMEOFSPOUSE: ARMANDloE.ASIO
OCCUPATION: INCOME: 1 000 ANN UALLy/MONTHLY±gQ,QgQr_Q°

IF EMPLOYED, PLEASE STATE:


NAME OF EMPLOYER: -RADE NAME:

ADDRESS: ADDRESS!
TEL NO. NO.OF YEARS TEL NO. NO. OF YEARS
KIND OF BuSINESS:
.KIND OF BUSINESS:
POSITION OCCUPIED: CAPITAL INVESTED:
NAME & DESIGNATION 0F SuPERloR: TRADE REFERENCE:

{lF THE SPACE PROVIDED IS NOT ENOUGH, USE BACK HEREOF)


BANKACCOUNTS:
CuRRENT ACC0u NT:
TIME AND/OR SAVINGS DEPOSITS:

REAL ESTATE AND/C}R PERSONAL PROPERTIES OWNED:


DATE AREA ASSESSED VALUE lNCUMBRANCE
ACQUIRED LOCATIC}N OF DESCRIPTION OF LAND LAND IMPROVEMENT AMOUNT PAID
01/2011 SUBIC, ZAMBALES 120 SQM Php 8,000,000.00
06/2015 SuBIC, ZAMBALES HO_rsQm PHP 15,000,000.00
UFE INSURANCE: AMOUNT
REALTIONSHIP WITH APPLICANT: SPOUSE
HOW LONG HAVE YOU KNOWN THE APPLICANT? 1989
HAVE YOU EVER BEEN A BORROWER OR CO-MAKER 0N A PROMISSORY
NOTE WITH ANY LENDING
lNSTITUTION? (PLEASE EXCLUDED RELA"VE) J!9
NAM E OCCUPATION ADDRESS

The foregoing statement and representation are true and correct and made for the purpose of
including the STRONGHOLD INSURANCE CO., lNC., to issue the bond applied for. This will also-serve as
an authorlty for the said company to verify from the above-mentioned pgrspns,,, bank and `€n"es the
veracity Of the above information I have declarecl.
dyDand
(signature)
SIGNED IN THE PRESENCE OF:

REPUBLIC OF THE PHILIPPINES)

)S,S

SUBSCRIBED AND SwbRN to before me this


_201_atthe
Affiant ewhibiting to me his/her Community Tax Certificate No.
issued at

Doc. No.
Page Np.
BOok No.
Series of

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