CLIENT REFERENCES
(Please supply the correct and updated contact numbers to avoid loan denial)
Client's Name
*
First Name
Last Name
Supplier 1:
*
First Name
Last Name
Business/Company Name:
Active Mobile Number:
*
Please enter a valid phone number.
Supplier 2:
*
First Name
Last Name
Business/Company Name:
Active Mobile Number:
*
Please enter a valid phone number.
Customer 1:
First Name
Last Name
Business/Company Name:
Mobile Number:
Please enter a valid phone number.
Customer 2:
First Name
Last Name
Business/Company Name:
Mobile Number:
Please enter a valid phone number.
Relative or Family Member 1
*
First Name
Last Name
Occupation/Position:
Active Mobile Number
*
Please enter a valid phone number.
Relative or Family Member 2
*
First Name
Last Name
Occupation/Position:
Active Mobile Number
*
Please enter a valid phone number.
Business or Office contact person 1
First Name
Last Name
Position:
Active Phone/Mobile Number
Please enter a valid phone number.
Business or Office contact person 2
First Name
Last Name
Position:
Active Phone/Mobile Number
Please enter a valid phone number.
Official business E-mail address:
*
example@example.com
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LOAN EXPOSURES
Active or existing loan/s with any financing or lending company (if applicable)
Do you have any active business loan with other financing/lending?
*
Not applicable.
Business loan with collateral
Business loan from bank/s
Yes, I have an active loan/s.
I have an ongoing application.
Other
Financing Name #1:
How did you apply?
Please Select
I applied myself.
My agent applied for me.
I received an SMS.
I received a CALL.
I received an E-MAIL.
Someone personally went to my business or residence.
OTHER
Last loan released:
Release Date:
/
Month
/
Day
Year
Date
Interest Rate:
Please Select
Above 3.5%
3.5%
3.25%
3.0%
2.75%
2.5%
2.25%
2.0%
Below 2.0%
Monthly Add=On Rate
Payment Term:
Please Select
12 months
9 months
6 months
3 months
1 Year
2 Years
OTHER
Financing Name #2:
How did you apply?
Please Select
I applied myself.
My agent applied for me.
I received an SMS.
I received a CALL.
I received an E-MAIL.
Someone personally went to my business or residence.
OTHER
Last loan released:
Release Date:
-
Month
-
Day
Year
Date
Interest Rate:
Please Select
Above 3.5%
3.5%
3.25%
3.0%
2.75%
2.5%
2.25%
2.0%
Below 2.0%
Monthly Add-On Rate
Payment Term:
Please Select
12 months
9 months
6 months
3 months
1 Year
2 Years
OTHER
Submit
Should be Empty: