LOAN APPLICATION FORM SECTION I

FULL NAME:...
CONTACT ADDRESS:...
NATIONALITY:...
COUNTRY:...
DATE OF BIRTH: ...
GENDER: ...
MARITAL STATUS:...
CURRENT POSITION HELD AT PLACE OF WORK: ...
ZIP/COUNTRY CODE:........ FAX:............. TEL:

MOUNT REQUIRED AS LOAN:...
PROPOSED TERM/DURATION OF LOAN: ... PURPOSE OF LOAN: ...
DO YOU HAVE ANY ASSETS:... ...

NO...IF YES GIVE A BRIEF DESCRIPTION/DETAILS BELOW:

My Regards

Mr Vick