Loan Application

Personal Information

First Name*

Middle Name*

Last Name*

Title*

Mr.

Miss.

Mrs.

Others.

Marital Status*

Single

Married

Others

Gender*

Male

Female

Date of Birth*

Email Address*

Phone No*

Residential Address*

Residential Type*

Means of Identification*

Identity ID/NO*

Occupational Information

Occupation*

Sector*

Current Employer*

Employment Office Address*

Employment Status

Self Employed

Employed

Net Monthly Salary/Income*

Date Monthly Salary Is Paid*

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Bank Information

Bank Name*

Account Name*

Account Number*

Account Type*

BVN Number*

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Loan Information

Loan Type*

Personal

Business

Amount*

Tenor*

Purpose for the Loan*

I hereby confirm that I am applying for the above credit facility and certify that all the information provided by me above and attached hereto is true, correct and complete. I authorize you to make any enquires you consider necessary and appropriate for the purpose of evaluating this application. I therefore authorize you to use any means and any force at your discretion you consider reasonable to recover the facility if I default and I hereby totally absolve you of any liability arising from your recovering at my default.