LOAN SME Loan Application Form (Appendix D) Applicant / Proprietor Full Name (Surname, Firstname, Othername) Applicant Address Phone Number Email Address Date of Birth BVN National ID / NIN / RC No. Business / Enterprise Details Business / Enterprise Name Business Address Type of Business Sole ProprietorshipPartnershipLimited Liability Company (LLC)CooperativeNGO/Not-for-profitOther Industry / Sector Year Business Established No. of Employees Annual Turnover (₦) Loan Request Loan Amount Requested (₦) Purpose of Loan Repayment Period 3 months6 months12 months24 months36 months48 months Proposed Source(s) of Repayment Description of Collateral (if any) Directors / Owners (Principal Officers) Director / Owner 1 Name Phone Email Director / Owner 2 Name Phone Email Director / Owner 3 Name Phone Email Supporting Documents (Upload) Allowed: pdf, doc, docx, jpg, png — Max size each 5MB Business Registration (CAC/RC) * Latest Audited Financial Statements / Management Accounts * Bank Statements (last 6 months) * Other Supporting Document (optional) Declarations & Signature I hereby declare that the information provided above is true and correct to the best of my knowledge. I confirm the declaration Full Name (Typed Signature) Date
