CREDIT APPLICATION

CREDIEXPRESS OR EXTRA LIMIT

City: Request date: (YYYY / MM / DD) Filing date: (YYYY / MM / DD)

BASIC REQUEST DATA

Monto solicitado: (en números) Amount requested: (in words) Plazo Solicitado: (en meses)
$

I authorize to deposit in account No. CREDIT LINE REQUESTED

Crediexpress Extracupo
Savings Current
Bank: Another:

BASIC INFORMATION OF THE APPLICANT

Type and Number of Document: Names: Last names:

C.C. C.E.

City of residence: Address of residence: Residence department:

Cell phone: Landline: Email:

ECONOMIC ACTIVITY - FINANCIAL INFORMATION

Actual Cargo: Fecha de Ingreso: Sueldo Actual: Antigüedad: (años) Company Name:
(AAAA / MM / DD)

Company Address: Company Phone: City / Municipality: Tipo de Contrato: Pensionado Duration:
Fixed Term Indefinite Term (months)

MONTHLY INCOME MONTHLY EXPENSES

Salary and/or pension $ Rent or housing expenses $
Fees, commissions, overtime $ Personal and family expenses $
Other verifiable income $ Other Credits (credit card) $
TOTAL $ TOTAL $
Detail other incomes:

EXCLUSIVE SPACE FOR THE USE OF THE EMPLOYEES' FUND OF OCCIDENTE PRIVATE SECURITY - ACCOUNT STATEMENT OF THE APPLICANT

Total Aportes y Ahorros: $ Aporte Mensual: $ Seniority as an Associate:

VALUE OF CURRENT LOANS

CREDIT LINE CREDIT LIMIT $
Approved Amount $ Current Balance $
CREDIEXPRESS
FREE INVESTMENT
OLD CLIENT
EDUCATION
VEHICLE
SOAT
ANOTHER:
TOTAL $
 AUTHORIZATIONS AND DECLARATIONS

AUTHORIZATION FOR RISK CENTER CONSULTATION AND REPORT

We authorize the Western Security Employees' Fund, and/or whoever in the future holds the status of creditor for the obligation(s) contracted by me(us) with the Employees' Fund.
Western Security so that for statistical, control, supervision and commercial information purposes to other entities, it reports to the Central Information of the Banking Association and
Financial Entities of Colombia and any other entity that manages databases for the same purposes, the birth, modification, extinction, and fulfillment of obligations incurred or that
We will incur, as a result of contracts made with the Employee Fund of Western Security or with whoever in the future holds the status of creditor or legitimate bearer of the promissory note,
depending on the case, or any other relevant economic personal data, the existence of overdue debts that have not been paid or the improper use of financial services. This
authorization includes not only the ability to report, process, and disclose but also to request information about my(our) business relationships with any other entity. The
Consequences of said authorization will be the consultation and inclusion of my(our) financial data in CIFIN, Datacrédito, and other entities that manage databases for the same purposes.
affiliated entities being able to know my (our) present and past behavior related to the compliance or non-compliance of my (our) obligations, with the eventual effect for
I (we) find myself (ourselves) unable to access the services provided by those affiliated entities. The permanence of the information reflecting non-compliance will depend on the moment.
in the manner in which the payment is made and how the collection processes are handled.

2. I (we) expressly authorize the Employee Fund of Western Security to conduct site inspections in order to verify the information contained herein.

3. Each of the undersigned, identified with the ID numbers that appear below our signatures, expressly request and authorize irrevocably the payer of the company with which
I/we work or we may work so that it retains at any time from my/our salary(s) and/or benefits of any nature, pensions, bonuses of any title, severance pay.
compensations and/or any other amount that the Company where I work(ed) or we might work, the amount determined by the Security Employee Fund
The West is indicated in manner, time, and place by this, to cover with it the total or partial amortization of capital, interest, and other concepts of the credit that the Employees' Security Fund
from the West has approved me(us) through this request; I (we) also expressly authorize that the amounts withheld by the Paying Officer be delivered to the Employee Fund.
from Western Security precisely in order to fully or partially cancel the debt that may arise from this request and the others that are under my (our) responsibility.

4. Likewise, in the event of my (our) irrevocable withdrawal from the entity or company, I (we) authorize the payer to withhold from my (our) salaries, social benefits, pensions, and/or severance.
and compensations to which I am entitled, the balance that I owe to the Western Security Employees Fund for this credit as of that date, and other amounts that are in my (our) possession
cargo.

5. I (we) hereby accept the amount, term, and interest rate approved by the Western Security Employees Fund as a result of the review of my (our) credit application.

6. AUTHORIZATION FOR COMPENSATION. I (we) authorize the Employee Fund of Security of the West to offset the obligations under my (our) responsibility with any individual deposit.
jointly, I/we hold (hold) in the Employee Fund of Security of the West. This authorization does not constitute any obligation for the Employee Fund of Security of
West.

I (we) certify that these discounts do not affect my (our) minimum vital.

8. WE DECLARE THAT THE INFORMATION PROVIDED IN THIS APPLICATION MATCHES THE TRUTH AND WE ASSUME FULL RESPONSIBILITY FOR ITS ACCURACY, IN
CERTIFICATE OF HAVING READ, UNDERSTOOD, AND ACCEPTED THE TERMS OF THIS INFORMATION, WE SIGN THIS DOCUMENT.

SIGNATURE OF THE APPLICANT

C.C. No.
ISSUED IN:
Index fingerprint right

RESULT OF THE STUDY

Study Date: Act No. Approved Denied Postponed

Monto Aprobado: $ Plazo (meses): Interest Rate: Approving Body:

OBSERVATIONS

AUTHORIZED SIGNATURE