Loan Application

Step 1: Personal Information

First Name *

Please enter your first name

Last Name *

Please enter your last name

ID Number *

Please enter your ID number

Gender *

Please select your gender

Marital Status *

Please select your marital status

Account Number *

Please enter your account number

Residential Address *

Please enter your address

Postal Address *

Please enter your postal address

Step 2: Financial Information

Monthly Income

Salary (Net - After Deductions) *

Please enter your net salary

Commission

Pension

Own Business Income

Total Monthly Income

Living Expenses

Groceries *

Please enter groceries cost

School Fees

Transport Cost *

Please enter transport cost

Total Monthly Expenses

Monthly Contractual Payments

Home Loan Account

Home Rental

Credit Card/Monthly Payment

Personal and Micro Loans

Educational Loan

Insurance (Short & Long Term)

Car Payments

Cell Phone Contract

Other Credit

Total Contractual payments

Step 3: Employment Information

Occupation *

Please enter your occupation

Payslip/Employee Number *

Please enter your employee number

Company Name *

Please enter your company name

Company Telephone *

Please enter company telephone

Gross Monthly Salary *

Please enter your gross salary

Payment Day *

Please select your payment day

Employer Address *

Please enter employer address

Step 4: Contact Details & Banking Information

Contact Number *

Please enter your contact number

Email Address *

Please enter a valid email address

Banking Details

Bank *

Please enter your bank name

Branch *

Please enter your bank branch

Bank Account Number *

Please enter your account number

Type of Account *

Please select account type

References

Reference 1 Name *

Please enter reference 1 name

Reference 1 Telephone *

Please enter reference 1 telephone

Reference 2 Name *

Please enter reference 2 name

Reference 2 Telephone *

Please enter reference 2 telephone

Step 5: Loan Details

Loan Type *

Please select a loan type

How much are you borrowing? *

Please enter the loan amount

Our intrest (%)

Intrest Charged Amount (N$)

Interest Charge Amount (N$)

Total Repayable (N$)

Number of Installments (max 5) *

Please enter number of installments

Installment Amount (N$)

First repayment due Date *

Please select first due date

Last repayment due Date *

Please select last due date

Final Repayment Date

Signing Details

Signed at(place name):*

Please enter signing place

Signed on(date Signed): *

Please enter signing day

Signed in(date month): *

Please select signing month

Year *

Please enter signing year

Step 6: Document Upload

Payslip *

Choose Payslip File

Please upload your payslip

ID Copy *

Choose ID Copy File

Please upload your ID copy

Bank Statements

Bank Statement Type *

Single Merged PDF

Separate Files

Please select bank statement type

Step 7: Digital Signatures

Borrower Signature *

Please provide your signature

Witness Signature *

Please provide witness signature

Step 8: Review Your Application

I agree to the terms and conditions and confirm that all information provided is accurate *

Please accept the terms and conditions