PDF PERSONAL LOAN APPLICATION - First Bank of Nigeria
CONSUMER BANKING PRODUCTS
PERSONAL LOAN APPLICATION
CONFIDENTIAL
PERSONAL INFORMATION DETAILS
Name
(Surname/First) & Other names)
Date of Birth:
DD
MM
YYYY
Title Telephone Number
Marital Status: Married
Single
Gender: Male
Female
Residential Address:
Landmark (if any):
Widowed
Divorced
E-mail address:
Mother s maiden name:
Permanent Home Address:
Landmark (if any):
Ownership of Residence:
Yes
Mobile Telephone:
No
If NO, state length of time at rented home:
Years at Current Address:
Years at Current City:
International Passport Number:
Driver s License Number:
No. of Dependants:
No. of Cars owned:
Name of Next of Kin:
Relationship:
Address:
Name
of
Spouse
(Surname/First) & Other names)
Spouse place of Employment:
Spouse Employer Address:
RELATED PARTY INFORMATION
Related Party [any relationship with Bank's Top Management Officers (AGM & above) or its Directors] If yes, please provide details: Name of Related Party
Relationship Details (tick as appropriate)
Father
Mother Wife
Husband
Son/Daughter's Spouse
Brother/Sister's Spouse
PROFESSIONAL INFORMATION DETAILS
Others (please specify)
Phone No: Title:
Spouse length of employment: Annual income of Spouse:
Yes
No
Brother
Sister
Son Daughter Nephew
Niece
Educational Qualifications: First degree Type of Employment: Paid Employment:
HND
School Cert.
Self Employment:
Diploma/NCE
Other Qualifications
Age of Business (if self employed)
Name of Previous Employer:
Phone No:
Address of Previous Employer:
Name of Current Employer: Land Mark (if any):
Employment Status:
Full Employment:
Contract:
D D MM Y Y Y Y
Expiry date of Contract (if any):
Employment Classification:
Junior Staff:
Senior Management:
Senior Staff: Executive Management:
Junior Management: Others:
Length of Service:
Destination:
Income details: Net Annual Income:
Monthly income:
Quaterly income:
Confirmation Status? Yes
No
First Time Request? Yes
No
Does your employer pay gratuity/final entitlement?
Yes
No
1
Loan #2_13
CREDIT FACILITY REQUEST
Loan Type: Personal Loan
Mortgage
Auto Loan
Household Equipment
Loan Amount:
Proposed Tenure in Months: 12 Months
24 Months
36 Months
Applicable to Personal Home Loan
Outright Purchase:
Home Construction:
Equity Refinance:
Asset Category
Asset Description
Make
Model
Others
others
Cost
Loan Purpose
Equity Contribution
Net Amount
NOTE THAT EQUITY CONTRIBUTION IS A MINIMUM OF 20% OF THE ASSETS COST AND PURCHASES CAN ONLY BE MADE FROM A LIST OF APPROVED VENDORS
Proposed mode of re-payment: Monthly
Quarterly
Others
DD
Proposed Repayment Date:
PLEASE NOTE THAT LATE REPAYMENT/BOUNCED CHEQUES WILL ATTRACT PENALTIES
BANK ACCOUNT INFORMATION
Account Relationship with FirstBank
Branch
Account Type
Please note that customers are required to maintain or open a current account with FirstBank
Account Number
Account Age
Account Relationship with other Banks
Bank
Branch
Account Type
Account Number
Account Age
OTHER BORROWINGS
Existing Bank Borrowings
Name of Lender
Type of Loan
Balance Outstanding
Average repayment per Installment
Repayment frequency
Mode of re-payment: Monthly
Quarterly
Others
COLLATERALS
Legal Mortgage? Yes
No
Stocks?
Yes
No
Cash Covered? Yes
No
Payment domiciliation Yes
No
DD
Proposed Repayment Date: Other security arrangements
I / WE CONFIRM THAT THE INFORMATION PROVIDED BY ME/ US IS TRUE, CORRECT AND COMPLETE I / WE HEREBY AGREE THAT THE INFORMATION I/WE HAVE PROVIDED ABOVE WILL BE USED BY THE BANK TO UPDATE MY BANKING RECORDS FROM TIME TO TIME I / WE AGREE TO INFORM THE BANK FROM TIME TO TIME, IF THE INFORMATION PROVIDED ABOVE CHANGES
I CERTIFY THAT ALL THE INFORMATION PROVIDED BY ME ABOVE IS TRUE, CORRECT AND COMPLETE. I AUTHORISE YOU TO MAKE ANY ENQUIRY YOU CONSIDER NECESSARY AND APPROPRIATE FOR THE PURPOSE OF EVALUATING THIS APPLICATION
Authorised Signatories:
FOR OFFICIAL USE
D D MM Y Y Y Y
Date:
PLEASE NOTE THAT THE BANK WILL CHARGE ADMINISTRATIVE FEES FOR PROCESSING THIS APPLICATION
PLEASE CHECK THAT EVERY QUESTION HAS BEEN ANSWERED AND THE FORM HAS BEEN SIGNED ALSO. NOTE THAT PAGE 4 OF FORM 3800M IS TO BE PREPARED AND ATTACHED FOR ALL RETAIL PRODUCTS
Received by:
RELATIONSHIP MANAGER
Signature
D D MM
Date:
YYYY
BM
Signature
D D MM Y Y Y Y
Date:
2
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