7/27/2019 Appraisal and Application Form

1/5

RURAL BANK OF LANUZA, INC.

Bo. Puyat, Carmen, Surigao del Sur

APPRAISAL REPORT

APPLICANT:__________________________ AGE:____ OCCUPATION:_______________

SPOUSE :____________________________ AGE:____ OCCUPATION:_______________

RESIDENCE:__________________________________________________________________________________

REAL ESTATE COLLATERAL

1. Commercial/Residential/Industrial/Agricultural Land.OCT/TCT No._______________________________ TD No.________________________________

Registered Owner: ______________________________________________________________________________

Owner's Address:_______________________________________________________________________________

Date Registered:_____________________________ Lot & Block No.__________________________

Location:______________________________________________________________________________________

Average Depth:______________________________ Average Width:___________________________

Frontage:___________________________________ Surfacing of Street:________________________Type of Terrain:_________________________________________________________________________________

______________________________________________________________________________________________

Kind/Width of Sidewalk:___________________________________________________________________________

______________________________________________________________________________________________

Encumbrance/Annotation:_________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

Boundaries:____________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

Location/Description:___________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________________

Accessibility/Landmarks:__________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

Marketability:_________________________________________________________________________________________________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

Area (hectares or square meters) ________________

Value (per hectare or square meter) P ______________

Market Value P_______________ Appraisal Factor ________________ Appraised Value (A) P_______________

2. Improvements on Land.

Nature: _____________________________________Type:__________________________________________

Erected on Lot/Block No._______________________Roofing:________________________________________

When Constructed:____________________________When Remodelled:_______________________________

Make of Surrounding

Building:_____________________________________________________________________________

Type of Neighborhood:__________________________Painting Condition:________________________________

Area of Ground and OtherFloors:___________________________________________________________________________

Others

(Specify):_______________________________________________________________________________________

_______________________________________________________________________________________________

Materials

Used:__________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________Compartments/Rooms:_____________________________________________________________________________

7/27/2019 Appraisal and Application Form

2/5

_______________________________________________________________________________________________

_______

_______________________________________________________________________________________________

Facilities:________________________________________________________________________________________

______________________________________________________________________________________________________________________________________________________________________________________________

Area of Ground and Other Floors (sq. meters) __________________

Reproduction Cost/area P_________________

Reproduction Cost P_________________

Estimated Useful Life __________________

Annual Depreciation P_________________

No. of Years Existing/Used __________________Total Depreciation P_________________

Present Market Value P_________________

Appraisal Factor __________________

Net Appraised Value (B) __________________

3. Appraised Value of Land and Improvements (A+B) P_____________

Multiply by Loan Value Factor ______________

TOTAL LOAN VALUE OF LAND AND IMPROVEMENTS P_____________

_________________________ _______________________________

Date of Actual Inspection Name and Signature of AppraiserDate

Prepared:_________________

Collateral Inspection and Appraisal authorized by:

_________________________

Manager/Loan Officer

_______________________________________________________________________________________________

Note: If collateral consists of several parcels of land or building improvements on a parcel of land, use anotherappraisal report sheet.

7/27/2019 Appraisal and Application Form

3/5

RURAL BANK OF LANUZA, INC.

Bo. Puyat, Camen, Surigao del Sur

APPLICATION FORM (For New Applicant)

APPLICANT:________________________ AGE:____ OCCUPATION:_______________________

SPOUSE:___________________________ AGE:____ OCCUPATION:_______________________

RESIDENCE:______________________________________ NO. OF DEPENDENTS:________________

BUSINESS ADDRESS:______________________________ Elem.___ H.S.___ Col.____

I. PURPOSE OF THE LOAN APPLIED FOR:

Specific Purpose Amount Date Needed

___________________________ ___________________ _______________________________________

___________________________ ___________________ _______________________________________

___________________________ ___________________ _______________________________________

___________________________ ___________________ __________________________________________________________________ ___________________ __________________________________________________________________ ___________________ _______________________________________

II. YEARLY INCOME AND EXPENSES:

SOURCES OF INCOME AMOUNT EXPENSES AMOUNT

___________________________________ __________ ________________________ ______________

___________________________________ __________ ________________________ ______________

___________________________________ __________ ________________________ ______________

___________________________________ __________ ________________________ ______________

III. OUTSTANDING OBLIGATIONS:

CREDITORS ADDRESS AMOUNT REMARKS

___________________ _______________________________ ________________ _____________

___________________ _______________________________ ________________ _____________

___________________ _______________________________ ________________ _____________

___________________ _______________________________ ________________ _____________

___________________ _______________________________ ________________ _____________

IV. MANNER OF REPAYMENT:

Daily (___) Monthly(___) Every 3 Mos.(___) Other Manner: ____________________

Weekly(___) Every 2 Mos.(___) Semi-Monthly(___) ____________________

Quincena(___) Quarterly(___) Annual(___) ____________________

V. CREDIT REFERENCES:

Bank & Other Creditors Type of Deposit Nature of Credit Extended

______________________ _____________ _____________________

______________________ _____________ _____________________

______________________ _____________ _____________________

______________________ _____________ _____________________

______________________ _____________ _____________________

VI. COLLATERALS OFFERED:

DESCRIPTION MARKET VALUE

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

7/27/2019 Appraisal and Application Form

4/5

VII. INSURANCE COVERAGE ON COLLATERAL OFFERED:

ITEM COVERED AMOUNT INSURANCE COMPANY

_________________________________________ ________ ______________________________________________________________ ________ _____________________

_________________________________________ ________ ______________________________________________________________ ________ _____________________

_________________________________________ ________ _____________________

_________________________________________ ________ _____________________

I, We hereby certify that all information herein and herewith furnished are in all respects true and correct and

I/we further agree that this document shall remain the property of the bank whether my/our credit request is grantedor not.

I/We authorize the bank to obtain other information as may be required in connection with this request and

I/we are aware that to use the proceeds of this loan for purpose other than those indicated herein is unlawful.

I/we hereby agree to make an advance payment of P____________to cover the cost of transportation and

other incidental expenses which shall be incurred in processing my/our loan application. Further, I/we agree to make

additional payments in case the advance is not sufficient to cover the cost of expenses incurred.

__________ ___________________________ ________________________

Date Name/Signature of Applicant Name/Signature of Spouse

7/27/2019 Appraisal and Application Form

5/5