MAVENCO — Member Information Data Sheet

Welcome

This is the MAVENCO Online Member Information Data Sheet. Please complete each tab in order, then submit your application from the last tab.

Before You Proceed, Be Ready To Upload

Copy of a valid government-issued ID showing your date of birth.
Copy of a valid ID with your signature (UMID, SSS, GSIS, PhilHealth, Pag-IBIG, Driver's License, Passport, and the like).
Proof of address, such as a utility bill for the last three months (water, electricity, telephone, credit card, bank statements, and the like).

Please ensure that the mobile number and e-mail address you provide are current and actually used by you. This will be MAVENCO's means of communication for all notices on your application and, once accepted, on your membership.

Purpose of This Form Membership Type

Click Personal Information above (or the Next button below) to continue.

1. Personal Data

Title

Member Name

Last Name First Name Name Extension (Jr, Sr, III) Middle Name

Birthdate Age Gender Birth Place

Country of Birth Civil Status Nationality Occupation

Occupation Status Educational Attainment Course Weight (kg)

Height (cm) Religious / Social Affiliation Sectors

Father

Last Name First Name Name Extension Middle Name

Mother's Maiden Name

Last Name First Name Middle Name

Spouse (if married)

Full Name Date of Birth Educational Attainment Gender Occupation

Primary ID

ID Type ID Number ID Issue Date ID Expiry Date

Secondary ID (in the absence of a Primary ID)

ID Type ID Number ID Issue Date ID Expiry Date

2. Address and Contact Data

Current Residence Address

Unit/Room No., Floor Building Name Lot/Block/Phase No. House No., Street Name

Subdivision Barangay Municipality/City Province

ZIP Code Residence Is Residence Since

Provincial Address

Unit/Room No., Floor Building Name Lot/Block/Phase No. House No., Street Name

Subdivision Barangay Municipality/City Province

ZIP Code Residence Is Residence Since

Contact Number

Home Phone Number Mobile Phone Number Office Phone Number E-mail Address

3. Beneficiaries / Dependents

No.	Last Name	First Name	Middle Name	Birthdate	Relationship

3. Supporting Documents

Upload clear photos or scans of the following. Accepted formats: JPG, PNG, PDF.

Valid Government ID (front)

UMID, SSS, GSIS, PhilHealth, Pag-IBIG, Driver's License, or Passport

Choose file

Valid Government ID (back)

Same ID as above, reverse side if applicable

Choose file

Latest Payslip

Most recent payslip showing your salary

Choose file

Cedula (Community Tax Certificate)

Current year's Community Tax Certificate

Choose file

Barangay Clearance

Clearance issued by your barangay of residence

Choose file

Proof of Billing

Utility bill, bank or credit card statement (last 3 months)

Choose file

Specimen Signature (3 copies)

Sign 3 times in the boxes below — this matches MAVENCO's specimen signature card — or upload a photo of your signature instead

2x2 ID Photo

Recent photo, white or plain background

Center your face in the frame, then capture.

Chrome / Edge: click the lock or camera icon in the address bar → set Camera to Allow → reload this page.

Safari: Safari menu → Settings for This Website → set Camera to Allow → reload.

Firefox: click the lock icon → Connection secure → More Information → Permissions → allow Camera → reload.

Also make sure no other app (Zoom, Teams, another tab) is currently using your camera, and that this page is open in its own browser tab rather than embedded in a preview window.

4. Pre-Membership Seminar Video

Please watch the pre-membership orientation video in full. This explains MAVENCO's programs, dues, contributions, and member responsibilities. You must complete viewing before you can submit your application.

I confirm that I have watched the complete pre-membership seminar video.

5. Declaration and Submit

Data Privacy Notice and Consent Form

We at MAVENCO — Mandaue City Public Market Vendors Multi-Purpose Cooperative value your privacy. We give this notice to inform you of the ways in which we collect and process your personal information and the means by which you can control, to a certain extent, these processes. As the personal information controller under Republic Act No. 10173 or the Data Privacy Act of 2012, MAVENCO Mandaue City Public Market Vendors Multi-Purpose Cooperative gives this notice to inform you of what personal information we collect and how your information will be processed and shared.

Information Collected

The type of personal/sensitive data that we collect depends on the product or service that you avail or intend to avail from us, including but not limited to:

Basic Member Data

Complete name — first, middle, surname, maiden name, spouse details, parent's details
Member Coop ID# / Passbook#
Date, place of birth
Gender and civil status
Member status in the cooperative (active, delisted, withdrawn)
Present and previous addresses, type of house ownership
Residence in the last two years
Government-issued IDs (SSS, TIN number, GSIS) and other IDs with expiration
Current and previous employment in the last five years — employer name, employer address, employer contact number/s, employer's TIN

Member's Loan/Credit Information

Original amount, date requested, released, and outstanding balance per loan type
Credit/loan status (current/delinquent/past due/date written off/others)
Mode of payment, amount paid, periodicity, and terms
Security/collateral type (assignment of deposits/share/REM/chattel)
Amount past due, age of account (days)
Adverse information (account under litigation, foreclosure proceedings ongoing, small claims court filed cases, resolution of disputes taken)
Loan updates status date

Additional Personal Data Collected Over the Course of Our Relationship With You

Over the course of our relationship, we may collect data about you including but not limited to your transactions, account history and information, and inquiries about our products and services. Personal data that we collect is authorized under:

Republic Act No. 9160, or the Anti-Money Laundering Act of 2001, to verify the identity of individuals;
Republic Act No. 9510, or the Credit Information Act, for the submission of personal and credit data of borrowers to the Credit Information Corporation (CIC);
Republic Act No. 6938 as amended by RA 9520 (Philippine Cooperative Code of 2008), for the submission of member's personal and membership data to the Cooperative Development Authority (CDA);
SMS (Short Messaging Service), a service for sending messages to individual members through mobile phones that use the global system for mobile communication, in text format, for real-time confirmation of transactions made to the cooperative.

Purpose of Collection

The information about you will be processed only according to the following purposes:

Availment of the cooperative's products and services;
Establish, confirm, update, and review customer records;
Conduct customer risk, capacity, and suitability assessment;
Perform internal business operations such as credit and risk management, product development and planning, market research, audit, and administrative purposes;
Any other legitimate business purpose that is necessary and related to the fulfilment of the contract between you and the cooperative;
Any other legitimate business purpose that the cooperative may deem necessary; and
Any other processing that is necessary to comply with a legal obligation.

Data Sharing and Outsourcing Agreements

The Cooperative shall also have the discretion to enter into data sharing agreements with the Philippine Cooperative Central Fund Federation for the purpose of establishing a Cooperative Credit Information System. The Cooperative may also provide your personal and sensitive information, in the ordinary course of business, to the following parties for any of the purposes set out above:

Any agent, contractor, or third-party service provider who provides relevant services to the Cooperative;
Credit bureaus or credit reference agencies;
Any regulatory, government, tax, law enforcement, or other agency or authority, or clearing house, for the purpose of complying with applicable laws and regulations.

We assure you that your personal information will be protected according to the data protection principles under RA 10173 and its implementing rules and regulations, and guidelines issued by the National Privacy Commission.

Rights of Data Subjects Under RA 10173

Under RA 10173, we inform you that you have the following rights:

Right to access your personal data;
Right to require the correction of any inaccurate data;
Right to request destruction of personal data pertaining to you that is no longer necessary for the purpose for which it was obtained, subject to the procedures prescribed by the Cooperative, in regard to which you may contact the Cooperative's Data Protection Officer or Manager.

I, whose name appears above, confirm that all the information disclosed in this Member Information Data Sheet is correct and complete. Any changes in the foregoing information shall be communicated to the Cooperative. I authorize the Cooperative to verify and investigate any and all information given by me which the Cooperative may deem appropriate.

I acknowledge and authorize the regular submission and disclosure of my basic credit data (as defined under Republic Act No. 9510 and its implementing Rules and Regulations) to the Credit Information Corporation (CIC), as well as any updates or corrections thereof.
I authorize the sharing of my basic credit data with other lenders authorized by the CIC, and credit reporting agencies duly accredited by the CIC.

I have read and understood the Data Privacy Notice and Consent Form above, and I give my consent to the collection, processing, and sharing of my personal data as described. I have read and agree to the declaration above, and confirm that the information I have entered in this form is true and accurate to the best of my knowledge.

Referred By Endorsed By

Membership Payment (via GCash)

Amount to Pay (₱)

Application Submitted

Thank you for completing your MAVENCO Member Information Data Sheet. Your application will now be reviewed by the Membership Records Department (MRD).

Please allow a few working days for the review. MAVENCO will contact you using the mobile number or e-mail address you provided if any additional information or documents are needed.

Mandaue City Public Market Vendors Multi-Purpose Cooperative (MAVENCO)

Member Information Data Sheet

Welcome

Before You Proceed, Be Ready To Upload

Valid Government ID (front)

Valid Government ID (back)

Latest Payslip

Cedula (Community Tax Certificate)

Barangay Clearance

Proof of Billing

Specimen Signature (3 copies)

2x2 ID Photo

Data Privacy Notice and Consent Form

Information Collected

Additional Personal Data Collected Over the Course of Our Relationship With You

Purpose of Collection

Data Sharing and Outsourcing Agreements

Rights of Data Subjects Under RA 10173

Application Submitted