AMD Form N‐01a Revised July 2013 BANGKO SENTRAL NG PILIPINAS ASSET MANAGEMENT DEPARTMENT Telephone Nos. 306‐3422, 306‐3423 306‐2914 BUYER’S INFORMATION SHEET (For Individuals) (Please complete required information. If not applicable put N/A.) BUYER’S PERSONAL DATA Last Name: First Name: Middle Name: Permanent Home Address: ( No. Street, Subdivision, Barangay, City/Municipality, Province) Home Tel. No.: Home Ownership: Owned Mortgaged Rented at P _____________ Living With Relatives Present Home Address: ( No. Street, Subdivision, Barangay, City/Municipality, Province) Home Tel. No.: Date of Birth: Place of Birth: Age: Sex: Male Female Civil Status: Single Married Annulled Widow/er Legally Separated No. of Dependent/s: Nationality: ACR/No. SIRV / SRRV No., if applicable TIN: Fax No.: Cellphone No.: E‐Mail Address: Government Issued ID Issued By and No.: Date and Place Issued: IF EMPLOYED IF ENGAGED IN BUSINESS Company/Institution: Business or Trade Name: Company Address: Nature of Business: Telephone No.: Business Address: Gross Monthly Income: Net Income for the Immediately Preceding Year: Other Source of Family Income Source / Nature Amount per Year ______________________ P ______________ ______________________ ______________ References Name Address Contact No. _______________ __________________ _____________ _______________ __________________ _____________ SPOUSE’S PERSONAL DATA Last Name: First Name: Middle Name: Date of Birth: Citizenship: Age: TIN: Cellphone No.: Email Address: Company/Employer/Business Name (if self‐employed): Company/Employer/Business Address: Office Landline: EXISTING LOAN ACCOUNTS/OUTSTANDING CREDITS (Please use a separate sheet, if necessary) Type of Loan: Bank / Financial Institution / Creditor & Address: Original Amount: Monthly Payment: Outstanding Balance: Maturity Date: OTHER ASSETS (Please use a separate sheet, if necessary) CREDIT HISTORY Type of Property/Investment: (e.g. house, car) Do you have an existing loan with other banks, financial institutions or government agencies such as PAG‐IBIG, GSIS or SSS ? Yes No If yes, please give details and submit proof of last amortization payment Are there cases, past or pending, civil or criminal, filed against you involving non‐payment of obligations or mishandling or issuance of bouncing checks? Yes No If yes, please state the nature and status of the case . ____________________________ Location/Description: Estimated Value: CERTIFICATION I hereby certify that the above statements are true, correct and complete to the best of my knowledge and belief and hereby agree that any misrepresentation or non‐disclosure of a material fact shall be a ground for the disapproval of my offer. I agree to notify the BSP of any change in my personal circumstances and/or any material change in the data stated herein. I likewise authorize the BSP to undertake whatever investigation or verification to check the validity or information contained herein. Lastly, I understand that it may be a criminal offense punishable by fine or imprisonment, or both, to knowingly make untruthful statements or related falsehoods upon any material matter concerning any of the above statements under the criminal laws of the Philippines. ____________________________ _____________________________ Date Signature Over Printed Name JURAT DOCUMENTARY REQUIREMENTS Republic of the Philippines) City of Manila ) S.S. SUBSCRIBED AND SWORN TO BEFORE ME THIS ______ DAY OF _______, 2011 AT ____________ BY ___________________________ __________________ ___________________ (Name of Buyer) Com. Tax Cert. No. Date and Place of Issue Doc No. _____________ Page No. ____________ Book No. ____________ Series No. ___________ Put a mark on the items submitted: ( ) Proof of Income (latest Income Tax Return, Payslip, etc.) ( ) Certificate of Employment ( ) DTI Certificate of Registration/Business Permit (photocopy) ( ) One passport size ID picture ( ) Government Issued ID & BIR TIN ( ) Statement of Bank Account or Photocopy of Passbook ( ) Bank Certification on Investment, if any (photocopy) ( ) For non‐resident alien – Affidavit on Total Landholdings ( ) Special Power of Attorney, if represented For TCT No. _________________ Location _________________ Paste Passport Size ID Photo Here

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Information Sheet for buyers of BSP foreclosed lots

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AMDFormN01aRevisedJuly2013

BANGKOSENTRALNGPILIPINAS

ASSETMANAGEMENTDEPARTMENTTelephoneNos.3063422,30634233062914

BUYERSINFORMATIONSHEET(ForIndividuals)

(Pleasecompleterequiredinformation.IfnotapplicableputN/A.)

BUYERSPERSONALDATALastName: FirstName: MiddleName:

PermanentHomeAddress:(No.Street,Subdivision,Barangay,City/Municipality,Province)

HomeTel.No.: HomeOwnership:OwnedMortgagedRentedatP_____________LivingWithRelatives

PresentHomeAddress:(No.Street,Subdivision,Barangay,City/Municipality,Province)

HomeTel.No.:

DateofBirth: PlaceofBirth: Age: Sex: Male Female

CivilStatus:SingleMarriedAnnulledWidow/er LegallySeparated

No.ofDependent/s:

Nationality:

ACR/No.SIRV/SRRVNo.,ifapplicable

TIN:

FaxNo.:

CellphoneNo.:

EMailAddress:

GovernmentIssuedIDIssuedByandNo.:

DateandPlaceIssued:

IFEMPLOYED IFENGAGEDINBUSINESSCompany/Institution: BusinessorTradeName:

CompanyAddress: NatureofBusiness:

TelephoneNo.: BusinessAddress:

GrossMonthlyIncome: NetIncomefortheImmediatelyPrecedingYear:

OtherSourceofFamilyIncomeSource/NatureAmountperYear______________________P__________________________________________________

ReferencesNameAddressContactNo.____________________________________________________________________________________________

SPOUSESPERSONALDATALastName: FirstName: MiddleName: DateofBirth:

Citizenship: Age: TIN: CellphoneNo.: EmailAddress:

Company/Employer/BusinessName(ifselfemployed): Company/Employer/BusinessAddress: OfficeLandline:

EXISTINGLOANACCOUNTS/OUTSTANDINGCREDITS(Pleaseuseaseparatesheet,ifnecessary)TypeofLoan: Bank/FinancialInstitution/Creditor&Address:

OriginalAmount: MonthlyPayment: OutstandingBalance: MaturityDate:

OTHERASSETS(Pleaseuseaseparatesheet,ifnecessary) CREDITHISTORY

TypeofProperty/Investment:(e.g.house,car) Doyouhaveanexistingloanwithotherbanks,financialinstitutionsorgovernmentagenciessuchasPAGIBIG,GSISorSSS?YesNoIfyes,pleasegivedetailsandsubmitproofoflastamortizationpaymentAretherecases,pastorpending,civilorcriminal,filedagainstyouinvolvingnonpaymentofobligationsormishandlingorissuanceofbouncingchecks?YesNoIfyes,pleasestatethenatureandstatusofthecase.____________________________

Location/Description:

EstimatedValue:

CERTIFICATIONIhereby certify that theabove statementsare true, correctandcomplete to thebestofmyknowledgeandbeliefandherebyagree thatanymisrepresentationornondisclosureofamaterialfactshallbeagroundforthedisapprovalofmyoffer.IagreetonotifytheBSPofanychangeinmypersonalcircumstancesand/oranymaterialchangeinthedatastatedherein.IlikewiseauthorizetheBSPtoundertakewhateverinvestigationorverificationtocheckthevalidityorinformationcontainedherein.Lastly,Iunderstandthatitmaybeacriminaloffensepunishablebyfineorimprisonment,orboth,toknowinglymakeuntruthfulstatementsorrelatedfalsehoodsuponanymaterialmatterconcerninganyoftheabovestatementsunderthecriminallawsofthePhilippines._________________________________________________________DateSignatureOverPrintedName

JURAT DOCUMENTARYREQUIREMENTSRepublicofthePhilippines)CityofManila)S.S.SUBSCRIBEDANDSWORNTOBEFOREMETHIS______DAYOF_______,2011AT____________BY________________________________________________________________(NameofBuyer)Com.TaxCert.No.DateandPlaceofIssueDocNo._____________PageNo.____________BookNo.____________SeriesNo.___________

Putamarkontheitemssubmitted:()ProofofIncome(latestIncomeTaxReturn,Payslip,etc.)()CertificateofEmployment()DTICertificateofRegistration/BusinessPermit(photocopy)()OnepassportsizeIDpicture()GovernmentIssuedID&BIRTIN()StatementofBankAccountorPhotocopyofPassbook()BankCertificationonInvestment,ifany(photocopy)()FornonresidentalienAffidavitonTotalLandholdings()SpecialPowerofAttorney,ifrepresented

ForTCTNo._________________Location_________________

PastePassportSizeIDPhotoHere