Magnifica | Questionnaire Form Wizard by Ansonika

Salary Loan

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Personal Information.

Create Account. All fields are required.*

Title

BVN

First name

Last name

Marital Status

Gender

Phone Number 1

Phone Number 2

Personal Email Address

Create Password

NOTE: Dial *565*0# on your Bank registered mobile number to get your BVN

Contact Information.

Please fill with your details.*

Contact Address

City

State

Government Issued ID

ID Number

Upload Government Issue ID

Recent Passport Photograph

Utility Bill

Employment Details.

Please fill with your details.*

Employer (Coy/Organization)

Office Full Address

Office Phone Number

Official Email Address

Date Employed

Upload Staff ID

Staff ID No

Years in the Organization

Job Title/Designation

Employment Type

Monthly Net Salary

Salary Pay Day

Transaction Details.

Please fill with your details.*

Loan Amount (₦)

Duration/Tenor

Monthly Repayment

Loan Purpose

Bank Name

Account Number

Any outstanding loan monthly obligations*

Any obligations

If Yes, Amount

Character Witness & NOK.

Please fill with your details.*

Full Name

Residential Address

Relationship

Phone Number

Next of Kin Details*

Full Name

Relationship

Phone Number

Residential Address

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. !

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Salary Loan

Personal Information.

Create Account. All fields are required.*

Contact Information.

Please fill with your details.*

Employment Details.

Please fill with your details.*

Transaction Details.

Please fill with your details.*

Any outstanding loan monthly obligations*

Character Witness & NOK.

Please fill with your details.*

Next of Kin Details*

Thank your for your time. !

Thank your for your time
. !