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1
Step 1
Select Loan Type
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Traders Loan
Edu Loan
Payday Loan
Contract Finance Facility
Title
MR.
MRS.
MS.
Surname
First Name
Middle Name
Gender
Male
Female
Custom
Phone Number
Marital Status
Single
Married
Engaged
Home Address
Date Of Birth
date_range
Personal Email Address
email
Office Email
email
Current Employer
Office Address
Job Role
Grade
Length Of Service
Account Number
Bank Name
Account Name
Disbursement Account
(if Different from above)
Account Name
Bank Name
Repayment Mode
1
2
3
4
5
6
Repayment Source
Bank Verification Number
Net Monthly Salary
Loan Amount Needed
Tenor (In Months)
1
2
3
4
5
6
Loan Purpose
0
/
Name
Signature & Date
NEXT OF KIN
Title
MR.
MRS.
MS.
Surname
First Name
Middle Name
Gender
Male
Female
Custom
Phone Number
Relatioship
Address
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