Loan Application

Micro Lending

Personal Information

Full Name (First, Middle, Last)
Date of Birth (dd,mm,yyyy)
Gender
Taxpayer Registration Number (TRN)
Marital Status

Contact Information

Home Address
Cellular Number
Email Address

Employment Information

Place & Tenure Employment (Employer, years of employment)
Gross Salary (Specify: Weekly, Fortnightly, Monthly)

Loan Details

Loan Amount Requested
Preferred Repayment Amount & Terms ($10,000/Month)