PERSONAL DETAILS

First Name

Last Name

Email

Telephone (work)

Identity Number

CellPhone

Physical Address

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LOAN DETAILS

Loan Amount

Employer

Net Salary

Gross Salary

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BANK DETAILS

Bank Name

Payment Frequency
WeeklyFortnightlyMonthly

Account Number

Branch Code

Account Type
Current AccountSavings AccountTransmission Account

Payment Date

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OTHER DETAILS

(NEXT OF KIN)

Full Name

Contact Number

Physical Address

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OTHERS

AgreementI agree that a credit check may be conducted by Global Cash Loan Service and/or any of their financial business partners/providers and a copy sent to me to view in the privacy of my own home. I accept all terms and conditions as set on this website.