New Rosabon Personal Loan Form

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Personal Loan Application Form

RC N0: 142832

Personal Details
Title: Mr Mrs Miss Ms Dr Chief
Affix
Passport
Surname:
Photograph
First Name:

Other Names: Next Of Kin Details (must be above 18)


Name:
Nationality:

Email Address: Phone Number:

Bank Verification Number: Relationship:

Date of Birth : D D M M Y Y Address:

Gender : Male Female Email:

Phone Number 1:
Loan Details
Phone Number 2: Loan Amount Requested:

Home Address: Proposed Tenure (Months):

Loan Purpose:

City: State: LGA: Source of Repayment (Please choose one)

Moved Here In M M Y Y
(Please attach Utility Bill) REMITA Post-Dated Cheque

Residential Status: Tenant Outright Owner Mortgage Owners


Bank Details (Required to process your application)
Provided by Employer
Bank Name:
Means of Identification: Driver’s License NIMC ID Card
Bank Branch:
Voters’ Card International Passport Account Name:

ID Number: Account Category: Personal Account Corporate Account

Expiry Date: M M Y Y Account Number:

Account Type: Current Savings


Marital Status & Dependants
Single Married Seperated Widowed Divorced Preffered method of signing offer?
Via E Signature
Number of Children: (You will NOT need to print and scan the offer letter)

Via Physical Signature


Educational Status (You will need to print and scan the offer letter)

Primary Secondary Graduate Post Graduate


How did you hear about Rosabon?
Others (Please Specify): SMS Email Radio Flyers Social Media TV
Billboard Website Referral Salesperson
Employment Details
Others (Please Specify):
Employee Self Employed / Business Owner

Employer’s / Business Name:


Declaration
Company Address:
I of
_______________________________________________________ _______________________________________________________________________________________

have fully read and understood the terms and conditions in this
Rosabon Financial Services application form.
Official Email:
Therefore, I accept the terms and conditions as evident by my
Employment / Business Start Date: M M Y Y signature below.

Position / Designation: Kindly Note that all details of this transaction, including mails of the client, transaction
amount and transaction performance, including arrears shall be made available to our
Net Monthly Income: third party partners, credit registry bureau, and CRC Credit Bureau who share this
information with other financial institutions.
Salary Payday: D D M M

Signature of borrower:
For Self Employed and Business Owners only
Date (DD/MM/YY): D D M M Y Y
Occupation:

Number of Employees:

info@rosabon-finance.com www.rosabon-finance.com

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