Market-Moni Form

Market-Moni Form
Name*

First NameLast Name
House address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Type of business*
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
YES, if yes name the entity: ____________________________________________________NO
Loan Amount*
Duration*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Account Name*
Account number*
Bank Name*
Alternative Bank Account
Account Name*
Account number*
Bank Name*
TERMS AND CONDITIONS

·         Be informed that this loan is at an interest rate of 2% weekly.

· That you the debtor will be paying a weekly amount that consists of both the interest and the principal amount only and that you are not allowed to default.

·         That in the instance of any default, you are only allowed a grace period of 1 (one) day to pay after which we will commence recovery actions which includes contacting the union or market union you belong to, contacting your friends and family members and blacklisting you in the market where your business is located.

·         That if you fail to make payment for 2 weeks consecutively, we will take possession of any item bearing your name, your goods, or any item in your shop that bears your name or related to your title and use same in the repayment of your loan as well as interest until the loan is fully paid.
I have read the above terms and conditions stated and have agreed to it.
Date*

MonthDayYear
Date
Signature*

Clear
IDENTIFICATION CARD*

Cancelof
Should be Empty: