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Loan Application Form
Title
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Gender
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First Name*
Last Name*
Email*
Date of Birth*
Salary Account Number*
Salary Bank Account*
BVN*
House Address*
Place of Work*
Date of Employment*
State of Residence*
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Abuja Federal Capita Territory (FCT)
Phone Number*
REMITA/Employment No*
Last Salary Amount*
Loan Amount (₦50,000 - ₦500,000)*
Total Number of Repayments (1-6 months)*
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