Employment Type :

How frequently do you get paid?

Total Monthly Income :

Total Monthly Expenses :

How much do you want to borrow?

How long do you need to pay it back?

Have you taken a loan with us this year?

Yes No

Application Details

Description	Detail
Capital Borrowed	{ capital_out }
Total Interest	{ interest }
Total Fees	{ fees_incl }
Repayment Period	{ period }
Monthly Interest Rate	{ monthly_interest_rate }
Discount Rate	{ discount }
Instalment Amount	{ instalment_amount }
First Instalment Date	{ first_inst_date }
Last Instalment Date	{ last_inst_date }

Repayments Table

Additional Notes

The above quotation excludes voluntary and compulsory insurance amounts which will be discussed and concluded with you by our representatives.

This quotation is an indication of the instalment amount only, the final fees and interest may vary slightly depending on the number of days between your application date and the date the loan is concluded.

By clicking next you agree to the

Terms and Conditions

Choose identification type :

Identity Document Passport

Your Identity Number :

Your Cellphone Number :

Why do you need a loan?

Applicant Details

First Name :

Surname :

Gender :

Male Female

When were you born?

Select passport issuing country:

When does your passport expire?

Email Address (Optional) :

Reference 1

First Name :

Surname :

Reference Cellphone Number :

Relationship :

Reference 2

First Name :

Surname :

Reference Cellphone Number :

Relationship :

Employer Name :

Job Start Date :

Employee Code :

Job Title :

Branch:

Department :

Supervisor Full Name :

Work Phone :

Pay Frequency :

Pay Date :

Is Saturday a Work Day?

Yes No

Financial Institution :

Account Type :

Account Number :

Agent Code (Optional) :

Comments for Reviewer :

Signature :

Sign application