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Loan Application Form

Please complete all sections to submit your application.

A. Applicant Info
B. Employment/Business
C. Loan Details
D. Financial Info
E. Documents
F. AML & Declaration

Section A: Applicant Information

Full Name *

Middle Name

Lastname *

Date of Birth *

TRN *

Gender *

Marital Status *

Phone *

Email *

Home Address *

Parish *

Living Type *

Number of Dependents *

Next of Kin

Next of Kin #1 - Name *

Next of Kin #1 - Telephone *

Next of Kin #2 - Name

Next of Kin #2 - Telephone

Directions to Home *

Are you travelling overseas soon? *

Are you bankrupt or filing bankruptcy? *

Section B: Employment / Business Information

Employment Type *

Employer Name

Employer Address

Position / Job Title

Length of Employment (months/years)

Employer Contact (Name & Telephone)

Occupation

Net Pay (JMD)

Frequency of Pay

Business Name

Business Type

Years in Operation

Average Monthly Revenue (JMD)

* If you are employed, complete the employment section. * If self-employed or business owner, complete the business section.

Section C: Loan Details

Loan Type *

Purpose of Loan *

Loan Amount Requested (JMD) *

Preferred Repayment Term *

Repayment Period (months) *

How will the loan be used? *

Section D: Financial Information

Bank Name *

Bank Branch *

Account Type *

Account Number *

Other Income Sources (if any)

Monthly Expenses

Rent / Mortgage

Utilities

Food

Loan Payments

Other Expenses

Existing Loans / Debts (if any)

List existing loans/debts (institution & approximate balance)

Section E: Identification & Documentation

Please upload clear copies of the following documents.

Valid Government ID (jpg, png, pdf) *

TRN (jpg, png, pdf) *

Proof of Address (Utility bill, bank statement) *

Last 3 Pay Slips (if employed) *

Job Letter (jpg, png, pdf) *

Business Registration Documents (if applicable)

Section F: AML / Declaration & Consent

Source of Funds *

Are you or a close family member a Politically Exposed Person (PEP)? *

Is this application submitted digitally? *

Declared Total Income (JMD) *

Digital Signatures

Applicant Signature *

Applicant Signature Date *

Co-Applicant Signature (if applicable)

Co-Applicant Signature Date

I hereby declare that the information provided is true and complete, and I authorize the lender to verify this information and conduct credit/background checks.

By submitting this application, you consent to the processing of your data for loan assessment, AML/CFT checks and related purposes.