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    ZBFH IndividualLoanApplicationForm r3

    Uploaded by

    bobbycraftsmanzim

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    ZBFH IndividualLoanApplicationForm r3

    Uploaded by

    bobbycraftsmanzim
    11 views2 pages

    Original Title

    ZBFH-IndividualLoanApplicationForm-r3

    Copyright

    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
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    Download as pdf or txt
    11 views2 pages

    ZBFH IndividualLoanApplicationForm r3

    Uploaded by

    bobbycraftsmanzim

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    ZB Chambers, 2nd Floor, Corner 1st Street & George Silundika

    Harare, Zimbabwe
    Tel: +263 867 700 2005 Email: [email protected]

    INDIVIDUAL LOAN APPLICATION FORM


    Payroll Loan: Bus Loan: Loan Type:

    INDIVIDUAL LOAN APPLICATION FORM


    Title (Mr./Mrs./Dr/Prof): First Name: Surname:

    Maiden Name: Gender: Date Of Birth:

    Marital Status: Nationality: ID Number:

    Cell Number: WhatsApp: Highest Educational Qualification:

    Citizenship: Email Address:

    Residential Address: Permanent Address:

    Period at Current Address: Years: Months:

    Period at Previous Address: Years: Months:

    SPOUSE AND NEXT OF KIN DETAILS


    SPOUSE DETAILS NEXT OF KIN 1

    Full Name: Full Name:

    Phone Number: Relationship:

    Email Address: Phone Number:

    Address: Email Address:

    Address:
    NEXT OF KIN 2

    Full Name:

    Relationship:

    Phone Number:

    Email Address:

    Address:

    EMPLOYMENT DETAILS
    Business/Employer’s Name: Job Title:

    Business/Employer’s Address: Date of Employment:

    Name of Immediate Manager: Phone Number of Immediate Manager:

    Status of Employment: Permanent: Contract: Part time: Self Employed:

    Gross Salary: Net Salary: Employee Number:


    OTHER SOURCES OF INCOME

    SOURCE GROSS NET INTERVALS

    Are you related to any Qupa MFI employeees or directors? Yes: No:
    If YES state the name and relationship:

    PROPERTY OWNERSHIP
    Rented: Employer Owned: Mortgaged: Owned Without Mortgage: Parents owned:

    LIST OF PLEDGED ASSETS


    1: 1:

    2: 2:

    BANK/MOBILE ACCOUNT DETAILS


    BANK BRANCH ACCOUNT NUMBER

    LOAN WITH OTHER INSTITUTION (ALSO INCLUDE QUPA LOAN)


    INSTITUTION MONTHLY CURRENT LOAN MATURITY DATE
    INSTALLMENT BALANCE

    LOAN APPLICATION DATAILS


    Loan Amount: Loan Purpose:

    LOAN TENURE 1 2 3 4 5 6 7 8 9 12 Others (Specify):


    Would you like the following ZB life Cover? 6 Months: 12 months: 18 months: Other (Specify)

    DECLARATION
    I declare that the information given above is accurate and correct. I am aware that falsifying information automatically leads to decline of my loan
    application. I authorise Qupa Microfinance to obtain and use the information obtained for the purposes of this application from the recognised credit
    bureau. I authorise Qupa Microfinance to obtain references from friends, relatives, neighbors and business partners including visits to my home and
    verification of my assets. I undertake to provide all documents required by Qupa Microfinance and to update all records in the event of change of any
    personal details.

    Full Name: Signature and Date:

    FOR OFFICIAL USE ONLY


    Received & Checked by: Name: Signature: Date:
    Approved by: Name: Signature: Date:

    KYC CHECKLIST
    Copy of ID, Licence, Valid Passport
    Current Pay Slip
    Stamped 3 Months’ Bank Statement
    Mobile Statements
    Proof of Residence/Confirmation Letter Qupa Date Stamp:

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