\FORMAT OF DISCLOSURE STATEMENT ON SMALL BUSINESS/RETAIL/CONSUMER CREDIT(Appendix to Sec. 306 on Information to be Disclosed)
____________________________________
(Business Name of Creditor)
DISCLOSURE STATEMENT ON LOAN/CREDIT TRANSACTION
(As Required under R.A. No. 3765, Truth in Lending Act)
NAME OF BORROWER _____________________________________
ADDRESS_________________________________________________
| 1. LOAN AMOUNT | P | XXX | ||
| 2. OTHER BANK CHARGES/DEDUCTIONS COLLECTED1 | P | XXX | ||
| a. Documentary/Science Stamps | P __________ | |||
| b. Mandatory Credit Insurance | __________ | |||
| c. Others (Specify) | __________ | |||
| 3. NET PROCEEDS OF LOAN (Item 1 less Items 2 and 3) | P | XXX | ||
| 4. SCHEDULE OF PAYMENTS |
| a. Single payment due on | date | P XXX | |
| b. Installment Payments | (Please see attached amortization schedule) | ||
| 5. EFFECTIVE INTEREST RATE (Interest and Other Charges) | XXX% | |
| Explanation: The effective interest rate is higher than the contractual interest rate of % because of Item 2 deductions above. | ||
| 6. CONDITIONAL CHARGES THAT MAY BE IMPOSED (if applicable). Please specify manner of imposition: | ||
| a. Late Charge | P __________ | |
| b. Prepayment (penalty/refund) | __________ | |
| c. Others (Specify) | __________ | |
| ___________________ | __________ | |
| CERTIFIED CORRECT: | |||
| ________________________________________ (Signature of Creditor/Authorized Representative Over Printed Name) |
________________________________________ Position |
| ________________________________________ (Signature of Borrower over Printed Name) |
________________________________________ Date |
__________________________________________________________________________
AMORTIZATION SCHEDULE
(Sample Only)
| Installment (A) | Loan (B) | Principal (C) | Interest (D) | Total (E) | O/SBalance (F) |
| xxx | xxx | ||||
| 1 | xxx | xxx | xxx | xxx | |
| 2 | xxx | xxx | xxx | xxx | |
| 3 | xxx | xxx | xxx | xxx | |
| 4 | xxx | xxx | xxx | xxx | |
| 5 | xxx | xxx | xxx | xxx | |
| 6 | xxx | xxx | xxx | xxx | |
| 7 | xxx | xxx | xxx | xxx | |
| 8 | xxx | xxx | xxx | xxx | |
| 9 | xxx | xxx | xxx | xxx | |
| 10 | xxx | xxx | xxx | xxx | |
| 11 | xxx | xxx | xxx | xxx | |
| 12 | xxx | xxx | xxx | xxx | |
| Total | xxx | xxx | xxx |
Legends:
A – Number of installment periods based on loan term
B – Gross amount of loan
C – Installment payment on the principal
D – Installment payment on the interest
E – Total amortization payment for the installment period
F – Outstanding principal balance of the loan
Footnotes
- Notes
Itemize all charges including advance deductions
– Small business/Retail/Consumer Loans includes microfinance, auto (motor), salary, personal, medical, educational and other loans of similar nature
– This document contains the minimum information required to be disclosed to the borrower and may be enhanced to improve client information