Loan Application

WHAT TYPE OF LOAN ARE YOU APPLYING FOR *

PERSONAL DETAILS

Upload Passport Size Photo *

Click or drag a file to this area to upload.

Full Name *

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Date of Birth *

Gender *

Male
Female

Region *

Residential Address (Nearest Landmark) *

Account Number *

Marital Status *

Single
Married
Divorced
Widowed

Home Town *

Type of ID *

SSNIT
Ghana Card
Voters ID
Drivers License
Passport

Name of Spouse *

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Nationality *

TIN Number *

ID Number *

Telephone Number *

Email address *

EMPLOYMENT DETAILS

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Employer's(Business) Name *

Type of Business *

Employment Status *

Permanent
Contract
Self-employed
Unemployed
Partime/Casual

Staff ID Number

Employment Email Address *

Monthly Income

Current Station *

Business Address

Employment Phone *

Other Income? (Specify)

LOAN DETAILS

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Loan Amount Requested(GHS) *

Loan Balance in any (GHS) *

Preference Share Balance (GHS) *

Shares Balance (GHS) *

Net Monthly Income (GHS) *

Savings Balance (GHS) *

I promise to repay this loan by

Daily Installments
Weekly Installments
Monthly Installments

Number of Installments *

Have you contracted any loan before? *

Purpose of Loan (Provident)

Purpose of Loan (Agricultural)

Purpose of Loan (Business)

Mode of Re-Payment

Standing Order
USSD - *718*222#
Susu Collection
Counter Cash
Mobile Money
Post Dated Cheques

Processing fee: 2% and Interest on Facility: 4% per month

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Mode of Disbursment *

Mobile Money
Transfer to Existing Bank A/C

Bank Account Name

Bank Name

Please check this box if the account is your salary account

Mobile Money Number

Bank Account Number

Bank Branch

LOAN GUARANTORS DETAILS

First Guarantor's Details

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Full Name

Date of Birth

Age

Phone Number

Account Number

Account Balance (GHS)

Please Let Guarantor Sign Electronically or Upload Signature using next field

Nationality

Marital Status

Married
Single
Widowed
Divorced

Email *

Postal Address

Resdential Address

ID Type

SSNIT
Ghana Card
Voters ID
Passport
Drivers License

Please upload a a picture of guarantor's signature signed on a clean white paper

Click or drag a file to this area to upload.

Second Guarantor's Details

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Full Name

Date of Birth

Age

Phone Number

Account Number

Account Balance (GHS)

Please Let Guarantor Sign Electronically or Upload Signature using next field

Nationality

Marital Status

Married
Single
Widowed
Divorced

Email *

Postal Address

Resdential Address

ID Type

SSNIT
Ghana Card
Voters ID
Passport
Drivers License

Please upload a a picture of guarantor's signature signed on a clean white paper

Click or drag a file to this area to upload.

AGREEMENT TO GENERAL TERMS AND CONDITIONS

Electronic Sign(Please sign electronically or use the manual upload below)

Signature Picture Upload

Click or drag a file to this area to upload.

Please sign your signature on a plain white sheet and upload a clear picture of it

I declare that the above information is true to the best of my knowledge and agree to abide by the bye-laws of the Society; the loan policy and any variations set by the Management, Committee and/or the Loans Committee. I agree to pay an interest of 3% per month on reducing balance (19.5% per annum). In case I fail to repay this loan, I shall be liable to pay up collection expenses and fines of 20% on the unpaid balance. I again pledge to pay an insurance premium equal to 3% of the loan principal amount before the loan shall be disbursed to me. *

I AGREE TO THE ABOVE

Have Any Questions?

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PERSONAL DETAILS

EMPLOYMENT DETAILS

LOAN DETAILS

LOAN GUARANTORS DETAILS

First Guarantor's Details

Second Guarantor's Details

AGREEMENT TO GENERAL TERMS AND CONDITIONS

read the General Terms and Conditions BEFORE PROCEEDING