Form helpline Tel: +233 55 2222 400
APPLICANT DETAILS
Full Name
Full Name is required.
Date of Birth
Date of Birth is required, and applicant must be 18+ years old
Gender
Male
Female
One option is required.
Marital Status
Single
Married
Divorced
Widowed
One option is required.
Telephone/Mobile No(s)
Telephone/Mobile No (s) is required.
Email Address
Email Address is required.
Email Address Email is not valid.
House Address
House Address is required.
Postal Address
Postal Address is required.
Residence Status
Own House
Rented House
Other (Specify)
One option is required.
If Other (Specify)
This detail is required.
I.D Card Type
Ghana Card
Passport
Driver's Licence
NHIS
One option is required.
I.D no.
I.D no. is required.
LOAN DETAILS
Loan Amount (GHC)
Loan Amount (GHC) is required.
Purpose of Loan
Purpose of Loan is required.
Preferred Disbursement Date
Preferred Disbursement Date is required.
Disbursement Method
Cash
Bank
Momo
One option is required.
Monthly Income (GHC)
Monthly Income (GHC) is required.
Sales
Sales is required.
Sales Frequency
Daily
Weekly
Monthly
One option is required.
Loan Period/Duration
Loan Period/Duration is required.
BANK
Bank Account Number
Bank Account Number is required.
Bank Account Name
Bank Account Name is required.
Branch
Branch is required.
MOMO
Momo No.
Momo No. is required.
Momo Name
Momo Name is required.
Service Provider
MTN
TELECEL
One option is required.
EMPLOYER DETAILS
Present Employer's Name
Present Employer's Name is required.
Occupation
Occupation is required.
Employer's Phone No(s)
Employer's Phone No(s) is required.
Employer Email
Employer Email is required.
Employer Email Email is not valid.
Work Address
Work Address is required.
GUARANTOR DETAILS
Guarantor's Name
Guarantor's Name is required.
Occupation
Occupation is required.
Employer's Phone No(s)
Employer's Phone No(s) is required.
Guarantor's Phone No(s)
Guarantor's Phone No(s) is required.
House Address
House Address is required.
Work Address
Work Address is required.
EXISTING LOAN DETAILS
Do you have an existing loan with us or other financial institution
Yes
No
One option is required.
For each other Loan, include details of:
1. Name of Bank of FI
2. Branch
3. Current Loan/Overdraft Balance (GHC)
4. Monthly Installments (GHC)
if 'Yes', Provide Loan/Overdraft details below
if 'Yes', Provide Loan/Overdraft details below is required.
OTHER NECESSARY DOCUMENTS
Passport Photo
Upload ID
Recent Utility Bill (not older than 3 months)
Payslip (not older than 3 months)
Directional Sketch to Applicant's Residence/Closest Landmark
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