SME LOAN FORM SME Loan Application Form Applicant / Proprietor Information Full Name Address Phone Number Email Date of Birth BVN National ID / RC No. Passport Photograph Signature Company Information Company Name Registered Office Address Factory Address Landmark (If Any) Own Premises? YesNo Type of Company Limited LiabilityPublic LiabilitySole ProprietorshipCooperative Enterprise RC Number Membership Number Litigation Pending? YesNo If Yes, Name of Party Suit Number Previous Business Engaged In Parent Company Subsidiaries / Affiliates Tax ID (TIN) Company Phone Website Email No. of Employees Date of Incorporation Nature of Business Products / Services Date Business Started Authorized Share Capital (₦) Organization Membership Stakeholders / Shareholders / Directors (Ownership and Board Representation) Stakeholder 1 Name Title Marital Status SingleMarriedWidowed Date of Birth Gender MaleFemale Ownership % Designation Highest Education PrimarySecondaryONDHNDBScMastersDoctorate ID Type International PassportDriver's LicenseVoter's CardNational ID ID Number Issuance Date Expiry Date BVN TIN Residential Address Own Residence? YesNo Years at Address Nationality Passport Photograph Signature Stakeholder 2 Name Title Marital Status SingleMarriedWidowed Date of Birth Gender MaleFemale Ownership % Designation Highest Education PrimarySecondaryONDHNDBScMastersDoctorate ID Type International PassportDriver's LicenseVoter's CardNational ID ID Number Issuance Date Expiry Date BVN TIN Residential Address Own Residence? YesNo Years at Address Nationality Passport Photograph Signature Stakeholder 3 Name Title Marital Status SingleMarriedWidowed Date of Birth Gender MaleFemale Ownership % Designation Highest Education PrimarySecondaryONDHNDBScMastersDoctorate ID Type International PassportDriver's LicenseVoter's CardNational ID ID Number Issuance Date Expiry Date BVN TIN Residential Address Own Residence? YesNo Years at Address Nationality Passport Photograph Signature Corporate Shareholders Name of Company Registration Number Contact Person Educational Qualification HNDBScMastersDoctorate Identification Type National IDDriver's LicenseVoter's CardInternational Passport Passport Photograph Signature Credit Facility Request Applied Before? YesNo Loan Amount Requested Loan Purpose Loan Class Short TermMedium TermLong Term Loan Type Term LoanWorking CapitalOn-Lending Repayment Plan MonthlyQuarterlySemi-AnnualAnnual Existing Relationship With Other Financial Institutions Deposit Account Relationship With Other Banks: Existing Loan with Other Financial Institution: Collateral Company Main Contact / Chief Promoter Name Phone Email Position BVN Nationality Passport Photograph Signature Related Party Information Any relationship with BOI employees or Directors? YesNo If yes, provide details: Name Relationship Detail ColleagueFamilyFriend 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 Official Use Only Received By Relationship Manager Staff Number Reviewed By State Manager Staff Number Signature (Relationship Manager) Signature (State Manager) Declaration & Signature I hereby declare that all information provided above is true and correct. Full Name (Signature) Signature Date
