Downloaad Form Applicant ParticularsName(If an individual, please state surname first)Office AddressResidential AddressPhone *Date Of BirthBVN *0 / 11NIN *0 / 11Nature Of BusinessIdentification DocumentE.g. Driver’s License, National Identification Number, International Passport / Voter’s CardPolitically Exposed Person (PEP)YesNoNature Of FacilityWorking Capital FinanceBusiness Asset FinancePersonal Asset FinanceInventory FinancePurchase Order FinancePurpose Of The FacilityFacility AmountPreferred Mode Of SettlementProposed Collateral/SecurityFacility TenureApplication FeeAll Payments should be paid into the following accountsACCOUNT NAME: ACCOUNT NUMBER: BANK NAME:Particulars Of signatory to the accountNamePhoneAddressAdd itemRemove itemParticulars Of Refrees / GuarantorsNamePhoneAddressAdd itemRemove itemAdditional InformationIf AnyConsent *Attestation & Agreement: I hereby attest that all information supplied by me on this form is correct. I also wish to confirm that I shall abide by all conditions governing this contract and fulfill all pledges and obligations expected of me on the specified dates. I also agree that in case of default, the collateral provided by me shall be applied in full or partial repayment of the facility.Apply