Financial Information. Number of credit card(s) held 1-2 3-5 More than 5 None Loan(s) with BIDV: Yes No Loan(s) with other credit institutions: Yes No Full name*: Relation with primary cardholders*: ID Card/Passport number* Date of issuance*: / / Place of issuance*: Company name* Mobile*: Company address*: Amount:In words: Collateral Account: opened via ………………………… Bank Branch ☐ Assets under ownership of Name of Co-owner/Secured Party: Borrower ☐ Assets under ownership of ID Card/Passport number: Borrower and co-owner(s) Date of issuance: Place of issuance: ☐ Assets under ownsership of Address: Home phone/Mobile number: third party No. Type of assets Serial Value Term Maturity date Issuing number Institution The borrower (and co-owner/Secured Party) undertakes that the pledged assets are legally owned by the borrower (and co- owner / secured party), and are not in dispute and not used to secure for any other debt repayment obligations
