WELCOME TO DUEKSAM! MY ACCOUNT MY WISHLIST LOG IN
ONLINE CREDIT APPLICATION
UNIT INFORMATION
Model
Note: You can also input any Model which is not in our website as long as related to motorcycle, appliance & power product. Our Sales Agent will contact as soon as they recieved and confirm if the product is available.
Category
Brand
Color
Terms
Area
Branch
UNIT INFORMATION
Requirements - Motorcycle Only
Driver's License No.
Note: For Motorcycle Intallment a Driver Licensed is required!
APPLICANT
First Name
Last Name
Contact No.
E-mail
Civil Status
Age
Address 1
Address 2
Landmark
Father's Name
Contact No.
Mother's Name
Contact No.
SPOUSE
First Name
Last Name
Contact No.
E-mail
Civil Status
Age
Address 1
Address 2
Father's Name
Contact No.
Mother's Name
Contact No.
SOURCE OF INCOME
Source of Income
Company
Contact No.
Company Address
Income Information / Capacity to Pay
LandMark
NUMBER OF DEPENDENTS
I Certify that the data I have disclosed in this credit application are true to my knowledge and hereby authorized DUEKSAM,INC. and it's authorized representatives to conduct the corresponding credit investigation thereon.
WARNING: SALES AGENTS are NOT AUTHORIZED to collect or receive payments. Any made or entrusted to any Person not remitted to the office is null and void. ALWAYS ASK FOR A RECEIPT.