Loan Form

It is a condition of this loan that you shall NOT make cash or transfer payments to any of our staff or their personal account BUT all repayments (principal, interest and bank charges etc) shall ONLY be by any of the following means: 1. Fidelity Bank Account: 411 000 2443; 2. Access Bank Account: 003 504 3469 or 3. By Cash ONLY on the cash counter within the bank to our cashier


Are you a New Customer? *

           

Moneytronics Account Number *

Please enter your account number with us  (10 Digits)

Account Officer Name

Please select the name of the Account Officer that introduced you to the bank or manages your account. If you don't have one, please leave blank

Title *

Name *

Bank Verification Number *

Gender *

Date of Birth *

Email *

Mobile Phone *

Please enter 11 digits mobile number starting with 0

Mobile Phone 2

Please enter 11 digits mobile number starting with 0

Residential Address *

Means of Identification *

Means of Identification ID Number *

ID Expiring Date

Marital Status & Dependents *

Number of Children *

Number of Dependents *

Educational Status *

Employer's/Business/Company Name *

Employment Status *

Industry *

Employment/Business Start Date *

Bank Account Number

Current Net Monthly Income (₦) *

Enter the amount of income you receive monthly

Current Pay Date *

Current Employer / Business Address

Employer/Business Phone No.

Work/Business Email

Loan Amount Requested (₦) *

Loan Amount in Words *

Loan Tenure *

Loan Tenure in numerals

Loan Tenure (Days/Weeks/Months) *

Security for Loan *

Which Loan Type are you applying for? *

Explain purpose for the Loan *

Identification Upload *

Please upload anyone of Current Valid Government issued identity such as Driver's License, International Passport, National ID or Voters card
You can upload up to 3 files

Utility Bill

Please upload any of the following documents that is not more than 3 months old - Rent Agreement with your landlord, PHCN bill or any other document that shows your name and the address together
You can upload up to 4 files

Bank Statement

If you have not been banking with Moneytronics MFB for more than 6 months, kindly upload your bank statement from another bank showing transactions for the past 6 months
You can upload up to 15 files

Passport Picture *

Please take a passport size picture of yourself, without any facial coverings or eyeglasses etc and upload here

Signature *

Please upload a scan copy of your signature

Enter Phone numbers of 4 Close Associates *

Guarantor's Name *

Guarantor's Address *

Guarantor's Bank Verification Number (BVN) *

Guarantor's Email *

Link to submit the guarantor form will be sent to this email id

Guarantor's Mobile Phone *

Please enter 11 digits mobile number starting with 0

2nd Guarantor's Name *

2nd Guarantor's Address *

2nd Guarantor's Bank Verification Number (BVN) *

2nd Guarantor's Email *

Link to submit the guarantor form will be sent to this email id

2nd Guarantor's Mobile Phone *

Please enter 11 digits mobile number starting with 0

3rd Guarantor's Name

3rd Guarantor's Address

3rd Guarantor's Bank Verification Number (BVN)

3rd Guarantor's Email

Link to submit the guarantor form will be sent to this email id

3rd Guarantor's Mobile Phone

Please enter 11 digits mobile number starting with 0

Disbursement Details

Account Name *

Account Number *

Bank Name *

Agreement *

Please Sign below *


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