INTERCREST CAPITAL LOAN APPLICATION

Complete all sections to submit your application

Step 1 of 6

Purpose of Loan

Total value of goods

Deposit available

Name of supplier

Number of goods

Security

Repayment period (Months)

Personal Details

Title

Initials

First name

Surname

Date of Birth

Nationality

Marital status

ID number

Telephone (Home)

Telephone (Work)

Cellphone

Residential & Employment Details

Postal Address

Number of dependants

Employment Details

Current Employer

Employer Address

Position

Period employed

Monthly gross salary

Monthly net salary

Family & References

Next of Kin

First Name & Surname

Relationship

Telephone

Address

Guarantor 1

Name

Telephone

Address

Occupation

Required Documents

Copy of ID/Passport

Passport photo

Current payslip

3 months bank statements

Review Your Application

Please review your information before submitting

All information must be accurate and complete. False information may result in application rejection.

I confirm that all information provided is accurate and complete