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Loan Details

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EMI *

Personal Details

First Name *

Last Name *

NRC# *

DOB *

Email *

Phone *

Province of Residence *

Town *

Address *

Asset Details

Asset Estimate *

Asset Name *

Asset Location *

Work Physical Address *

Bank Name *

Bank Branch *

Account Name *

Account Number *

Mobile Money Name *

Mobile Money Number *

Next of Kin

Next of Kin First Name *

Next of Kin Last Name *

Next of Kin Number *

Relationship with Next of Kin *

Next of Kin Physical Address *

Attachments

Upload Image of White Book (PNG/JPEG) *

Upload Front Image of vehicle (PNG/JPEG) *

Upload Back Image of Vehicle (PNG/JPEG) *

Upload Left Image of vehicle (PNG/JPEG) *

Upload Right Image of Vehicle (PNG/JPEG) *

Upload Chassis Image of vehicle (PNG/JPEG) *

Upload Mileage Image (PNG/JPEG) *

Upload Bank Statement (PDF) *

Selfie (JPG/PNG) *

NRC (PDF) *

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