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Loan Application

You are applying to borrow $ for years.

Enter your details below to complete the applicaton. Required fields are marked with an asterisk

Personal Details

You must provide your personal details

Full name *
Email address *
Telephone number *
Date of Birth *
ID Number *
Marital Status *
Number of dependants *
Preferred time of call (if needed)
Document type *
Proof of identity document *

Loan Details

Loan Amount *
Loan Term *
Purpose of loan *
How do you intend to pay this loan? *


Enter your current address and previous address if you have lived there for less than one year.

Building Name
House/Flat number and road *
Town *
Postcode *
Type of Residence *
Time at Residence *
Document type *
Proof of address document *
Previous Building Name *
Previous House/Flat number and road
Previous Town
Previous Postcode
Type of Residence
Time at Residence


Please provide details of your expenditure

Estimated monthly cost of Food and Groceries *
Estimated monthly cost of recreation *
Existing loan repayments *
Other Bills *
Enter the monthly amount *

Employment and Income

Please provide details of your employment and income

Company Name
Name of Employer
Job title
Monthly Net Income *
Time in this employment
Is your income paid directly into your bank account? *
Select additional income sources *

Bank Details

Your banking details are required to set up loan repayments

Bank Name *
Account Number *
Sort Code *
IBAN Number *
SWIFT Number *
Address *
Country *


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