Loan Application

Applicant's Details

Personal Details

Title (required)
—Please choose an option—Mrs.Mr.MissDr.

Surname (required)

First Name (required)

Other Names

Date of Birth (required)

Tel. Nos. (required)

Alternative Tel. Nos.

Personal Email Address (required)

Residential Address (required)

Line 1

Line 2

Nearest Bus Stop (required)

LGA (of Residence) (required)

State (required)

Marital Status (required)

No. of Children

Educational Status (required)
—Please choose an option—PrimarySecondaryGraduatePost-Graduate

Employment Status (required)
—Please choose an option—Full TimePart TimeTemporary ContractSelf-EmployedUnemployedStudentHouse-Wife

Sector (required)
—Please choose an option—PublicPrivate

Job Level

Job Function Title

Name of Employer/Address

Line 1

Line 2

Work Email Address

Current Pay Date (DD)

Current Net Monthly Income

Other Emoluments

Tax ID Number

Date Employed (DD/MM/YY)

If present employment is less than 1 year

Previous Employer

Duration Spent in the Previous Employment

Next of Kin

Name (required)

Relationship (required)

Telephone (required)

Residential Address (required)

Line 1

Line 2

Email Address

Loan Information

Purpose of Loan (required)

—Please choose an option—Portable GoodsTravel / HolidayRentGoodsHousehold MaintenanceSchool FeesWedding/Event

Other Expenses (Please Specify)

Amount Required (N) (required)

Tenor (required)

Above N200,000, Specify Details

Repayment Source (required)

No. of Loans and Total Taken in the Last 12 Months

Current Outstanding

Account to be Credited

Account Name (required)

Name of Bank (required)

Branch (required)

Account No. (required)

Sort Code (required)

Supporting Documents

All other documents not required at this stage must be submitted prior to disbursement

Bank statement for the last 3 months for borrower (required)

Bank statement for the last 3 months for Guarantor(s)

Passport photo

Letter of Indemnity

ID card for borrower (Driver’s license, Int’l Passport, Office ID)

ID card for Guarantor(s) (Driver’s license, Int’l Passport, Office ID)

Copy of Utility Bill of borrower

How did you hear about us? (required)

—Please choose an option—EmailFlyersSalesmanSocial MediaReferralWebsiteSMSBrochure

I agree to the Terms and Conditions below. (required)
                                       Terms and Conditions

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