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Loan application Payday

Loan Amount

For how long?(Months)

Repayment

Loan Type

Monthly Replayment

Net income per month (after taxes)

Reason for loan application?

Applicant Details

Surname

First name

ID number/Passport Number

Marital Status

Contact Details

Contact Number

Telephone No (Work)

Postal Code / Postal address

Address

Erf No/Apt No/Flat No

Street Name

City/Village

Region

Country

Employment Details

Employee Number (Optional)

Employer Name

Department(Optional)

Contract started

Job Title

Employment Status

Contract End Date

Employer Contact Number

Employer Telephone Number

Employer Job Title

Banking Details

Bank Name

Account Name

Branch Name

Account Number

Branch Code

Next Of Kin

Next Of Kin (1)

Surname

First Name

Phone/Mobile

Relation To Applicant

Next Of Kin (2 Optionally)

Surname

First Name

Phone/Mobile

Relation To Applicant

Debit Order Instruction

Account Name

Bank Name

Bank Account Number

Account Type

Branch Name

Branch code

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Documents

Copy of ID/Passport

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Verified 3 month bank statement

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Latest payslip

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Proof of address

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Signature

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Applicant Details

Contact Details

Employment Details

Banking Details

Next Of Kin

Debit Order Instruction

Documents

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