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No Middle Name
Suffix(Jr, Sr, II, III, IV, V)
N/A
Jr
Sr
II
III
IV
V
Gender
Male
Female
Date of Birth
I have read, understood, and agree to conform to the
TERMS AND CONDITIONS
of the Agreement.
I certify that all information I have disclosed in this Credit Application are true and correct to my own personal knowledge. I also authorize
Royal Star Appliance Marketing Inc.
to collect and process my personal data and to perform any related credit investigation procedures incidental thereto my appliance loan application, in compliance with
R.A. No. 10173 (Data Privacy Act.)
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