ATM Pay Loan | AGK Clover Lending Company Inc.

Personal Details

First Name: *

Middle Name: *

Last Name: *

Suffix:

Company Name: *

Birth Date: *

Gender: *

Male

Female

Civil Status: *

Mobile No.: *

Email Address: *

Home Address: *

City / Municipality: *

Province: *

Zip Code:

Co-worker Contact Reference:

Reference Name: *

Ref. Mobile No.: *

Company Details:

Position: *

Date of Employment: *

Gross Monthly Salary: *

Amount of Any Existing Loans:

Payroll Bank Name:

Loan Details:

Loan Amount: *

Proposed No. of Months to Pay: *

1 Month

2 Months

3 Months

Reason for Applying: *

Upload Requirements

Notes: Documents should be in following formats only: TIFF, JPG, BMP, PNG, GIF, PDF, DOC, DOCX, PPT, PPTX. Max file size per document is 2 MB.

1 Valid Gov’t. ID (Any of the ff.: Driver's License, Passport, UMID, Postal ID, SSS, Voter's ID, National Professional ID Card): *

Company ID: *

To process your application, we would like to ask permission for the following:

Pursuant to the Data Privacy Act of 2012 and its implementing Rules and Regulations, I express my consent for AGK Clover Lending Company, Inc. and its affiliate companies to use, collect, record, and consolidate my personal data for information, which shall be used for the purpose of processing my loan application.

I have read and agree with the Terms & Conditions *

Terms and Conditions

ATMPay Loan Application Form