LOAN DETAILS

---

Note! Fields mark with asterix (*) are required.

Step 1 of 4

Amount of Loan Request *
Purpose of Loan * Select your purpose of loan here Business Personal Asset Finance Mortgage Others
Tenor * select tenor here 1 Month 2 Months 3 Months 4 Months 6 Months 8 Months 12 Months
Source of Repayment *

PERSONAL INFORMATION

---

Title * None: MR. MRS MISS CHIEF DR. PROF. SIR LADY
Surname *
First Name *
Middle Name *
Phone Number *
Email Address
Contact Address

NEXT OF KIN DETAIL

---

Step 2 of 4

Email
Phone *
Contact Address
Next of Kin (Name)
Next of Kin (Phone Number)
Next of Kin (Emaill Address)
Next of Kin (Contact Address)

MARITAL STATUS

---

Marrital Status Married Single Divorced/Separated
If Married (enter your spouse's details)

INCOME DETAILS

---

Occupation
Monthly Income
Name of Employer

COLLATERAL DETAILS

---

Step 3 of 4

Name of Collateral
Value of The Collateral
Address
Do you have a Guarantor YES NO
Name of Guarantor
Phone Number of Guarantor
Email Address of Guarantor
Occupation
Contact Address of Guarantor

REPAYMENT PATTERN

---

Monthly Interest Repayment
Equal Monthly Repayment of principal & Interest
Repayment of principal & Interest Upon Maturity