Loan Product*—Please choose an option—Salary Earners - PrivateSalary Earners - Public (Civil Servants)Skilled LabourUnskilled LabourSelf Employed - ArtisanSelf Employed - Professionals

Surname*

First Name*

Middle Name*

Email*

Phone Number*

Date of Birth

Upload Passport (png, jpg, max 1.5mb, 1 by 1 aspect ratio)

Permanent Address

Employer's Name

Employer's Address

Employment Letter (png, pdf, doc, jpg, max 1.5mb)

Statement of Account (recent 6 months, png, pdf, doc, jpg, max 5mb)

Upload ID Card (png, jpg, max 1.5mb)

ID Card type —Please choose an option—National ID cardDriver's LicenceInternational PassportVoter's Card

Expiration of ID Card

Name of Bank —Please choose an option—Fidelity BankAccess BankCitibankDiamond BankEcobankFIrst BankFirst City Monument BankGlobus BankGuaranty Trust BankHeritage Bank PlcJaiz BankKeystone BankPolaris BankProvidus BankStanbic IBTC BankStandard Chartered BankSterliing BankSun Trust BankTitan Trust BankUnion BankUnited Bank for AfricaUnity Bank PlcWema BankZenith Bank

Account No

Type of Account —Please choose an option—Saving AccountCurrent AccountInvestment Account

BVN

Which other Bank(s)/Lending Institution are you borrowing from?

What is the total amount you currently owe from the various sources, including your employers if applicable

What is the total monthly repayment you make for the existing loans

Do you have any direct payment instruction on your bank account and for how much YesNo

Amount Been Paid

Do you have any payment obligation that is due but yet to be paid, if yes how much YesNo

Amount Due

Loan Amount (requested)*

Loan Purpose *

Repayment Period in months *

Source of Payment *

Guarantor's Surname

Guarantor's First Name

Guarantor's Middle Name

Guarantor's Email

Guarantor's Phone Number

Guarantor's Contact Address

Guarantor's Form (pdf max 1.5mb)

Guarantor's Passport (.png, .jpg, max 1.5mb)

Guarantor's Means of Identification (.png, .jpg, max 1.5mb)

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