Application Type

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Personal Details

Title *

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First Name*

Surname*

Gender *

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Marital Status *

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Place of birth:

Date of Birth*

Email:

Number of children:

Nationality:

Phone Number:

Residential Address:

Banking Details

Bank Name:

Bvn :

Account No :

Branch :

Account Type *

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Employment Details

Employment Type *

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Employers Name :

Telephone:

Employers Address :

Rank/Position/grade/level:

Job Title:

Date Of Employment

If less than 2 years in current employment:

Previous employer’s name & address:

Telephone

State your current annual salary *

State your monthly net salary *

Mode Of Salary Payment *

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Payment frequency e.g. monthly *

Other Source Of Income

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Introducer (Who introduced you to Fundit Finance Company Limited)

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Amount :

Purpose :

Tenor

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Do you have any current Loan

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Mode of Repayment

Should Employer Deduct it at Source

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Do you want to pay to company's Account

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Repayment start Date

End Date

Other Information

Name Of Spouse:

Spouse phone No:

Spouse Address:

Next of kin Name:

Next of kin Phone No:

Next of kin Relationship:

Next of kin Address:

Apartment Provided by

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When did you move to your residence:

Market Value of Apartment if:

Owned:

Mortgage:

Anticipate Change in Address

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If yes please state intended address:

Upload passport

Declaration

hereby declare that the information given above is true and correct to the best of my knowledge. If found untrue in part/ whole at any time, disqualify me. I also give authority that my signature (bearing my name) below is okay to authorize all my mandate

Signature:

Date :