Consumer Loan Application Form - United Bank for Africa

[Pages:2]Consumer Loan Application Form

Date

D DMM Y Y Y Y

Request: First time Yes

No

If No, loan account number

PERSONAL INFORMATION DETAILS

Current name Date of birth D D M M Y Y Y Y

Marital status:

Married

Single

widowed

Divorced

Gender: Male

Sex: Male

Female

E-mail address

Current residential address

Mobile telephone

Home telephone

Is residence: Owned

Rented

Length of time at current residence

International passport number

Drivers licence

No. of dependants

Number of cars currently owned

Name of spouse

Spouse place of employment

Spouse length of employment

Spouse employer address

Annual income of spouse

Female

PROFESSIONAL INFORMATION DETAILS

Highest educational level First degree

HND

School cert.

Diploma/NCE

Other qualifications

Type of employment: Paid employment Name of current employer Address of current employer Office E-mail Name of previous employer

Self employment

Length of service

(in years)

Age of business (if self employed)

Phone no

Address of previous employer

Employment status:

Full employment

Contract

Employment classification: Junior staff

Senior staff

Job title

Confirmation status

Income details: After tax annual income

Loan deductions (if any) currently taken out of salary

Monthly

Quarterly

CREDIT FACILITY REQUEST

Loan type

Amount required

Expiry date of contract (if any) D D M M Y Y Y Y

Junior management

Senior management

Executive management

Basic monthly salary Bi-Annually

Loan purpose

Annually

Tenure in months

Applicable to personal home loan

Outright purchase

Up to 60 months depending on loan type No-Wahala Loan - 36 months Executive - 48 months NAOC/Mobil - 60 months

Home construction

Equity refinance

First time request

Additional request



Asset category Type of asset

Make

Model

Invoice value

Equity Contribution

Net amount

Note that equity contribution is a minimum of 20% of assets cost and purchases can only be made from a list of approved vendors

Proposed mode of principal re-payment: Monthly

Quarterly

Annual

Others

BANK ACCOUNT INFORMATION Account relationship with UBA

UBA business office where salary is domiciled

Account owned

Account number

Length of account relationship

Account relationship with other banks

Name of other bank

Type of account (current, savings , deposits)

Account number

Duration at bank (In months)

Turnover (Total over last 6 months)

Loans outstanding (with other banks)

Type of loan

Amount outstanding

Collateral

Expiry date

Frequency

OTHER BORROWINGS

Mode of principal re-payment: Monthly

Quarterly

Please note that late repayments/bounced cheques will attract penalties

COLLATERALS

Others

Legal mortgage? Yes

No

Cash covered

Yes

No

Domiciliation of terminal benefits and gratuity

Yes

No

Other security arrangements

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.

Applicant signatories

Date

Please note that the bank will charge administrative fees for processing this application

FOR OFFICE USE

Please check that every question has been answered and the form has been signed also.

Received by: Name of relationship manager

Signature

Date



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