Loan Application

Name *

First

Middle

Last

Date of Birth

Marital Status

Home Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Number of Dependants

Primary Email Address *

Email

Confirm Email

Phone Number *

Landmark/ (Closest Bus Stop) *

How long have you lived at this address?

Existing Bank Account

Bank Name *

Account Name *

Account Number *

Bank Verification Number (BVN) *

Next of Kin Information

Prefix

Name *

First

Middle

Last

Is the Next of Kin *

Phone Number

Email *

Email

Confirm Email

Employment Information

Employment Status *

Employed
Self-Employed
Between Jobs
Other

Current Employer

Staff Emails *

Employers Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Popular Landmarks Closest to this Address

Net Monthly Income

Official Pay Day

Other

How did you hear about us?

Purpose of Loan

Loan Details

Loan Amount Requested (N) *

Loan Tenor (eg. 3 Months) *

Monthly Repayment

Attach Photo Passport *

Attesation

I certify that all the information provided by me above is true, correct and complete. I authorize you to make any enquiry you consider necessary and appropriate for the purpose of evaluating this application. (Please note that PERSONAL TRUST MICROFINANCE BANK reserves the right to charge administrative/other fee for processing this application).

Applicant's Human Resources Department (if Applicable)

Loan Application Form

Existing Bank Account

Next of Kin Information

Employment Information

Other

Loan Details

Attesation

Get in Touch With Us

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