MSH Loan Application Form
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Landline Phone Number
-
Area Code
Phone Number
Mobile Phone Number
*
-
Area Code
Phone Number
Date of Birth
*
-
Month
-
Day
Year
Date
Email
example@example.com
Loan Information
Upload the Requires documents to fast track the application!
Purpose
Personal
Business
Other
Loan Amount
*
Upload Your Bank Statement
*
Browse Files
*3 Months Bank Statemet
Cancel
of
Upload Your ID Here
*
Browse Files
*Make Sure it is Visible and clear
Cancel
of
Upload Payslip/Proof on Income
Browse Files
*Make sure it is visible and clear
Cancel
of
Borrower's Employment and Income Information
Fill in where Applicable
Name of Employer
If applicable
Employment Type
*
Self Employed
Employed
Other
Employer's Business Address (If Applicable)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years with the company/Organization
If applicable
Position / Title
If applicable
Nature of Business
If applicable
Gross Monthly Income
*
e.g R200
Gross Income from Other sources
Bank and Financial Information
Fill in the Account in which the money will be paid into if approved.
Bank Deposit Information
*
Confirmation and Consent
*
I hereby declare that the information provided above are true and accurate to the best of my knowledge, and without intend to mislead nor to misrepresent any details herein.
I understand that submission of this loan application does not guarantee loan approval. Mhlongo Shield Holdings (pty) Ltd reserves the right to approve or decline any application based on its evaluation criteria.
I consent to the collection, use, and storage of my personal information by Mhlongo Shield Holdings (Pty) Ltd for the purpose of processing this loan application, managing the loan, and fulfilling any legal or regulatory requirements.
I acknowledge that if I default on the repayment of my loan, I will be held liable for any legal fees, collection costs, or related expenses incurred by Mhlongo Shield Holdings (Pty) Ltd in recovering the outstanding amount.
I consent to Mhlongo Shield Holdings (Pty) Ltd contacting me regarding this loan application and any related matters using the contact details (phone number, email, and address) I have provided. I also agree to receive any relevant loan updates, reminders, and notifications via SMS, WhatsApp, email, or phone calls.
In the event of default on my loan, I authorize Mhlongo Shield Holdings (Pty) Ltd to pursue debt recovery through appropriate legal and financial channels, which may include third-party debt collectors.
Signature
*
Date
*
-
Month
-
Day
Year
Date
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Submit
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