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Requested Loan Details
Loan Type*
Loan Amount (Minimum $5000)*
Deposit Available
Loan Purpose (Brief description)
Personal Details
First Name*
Middle Name*
Last Name*
Date of Birth (eg: dd-mm-yyyy)*
Sex (Male/Female)
Driver's Licence Number*
Expiry Date (eg: dd-mm-yyyy)*
Please include all area codes with telephone numbers
Home Phone*
Fax Number
Mobile Phone
Email Address*
Marital Status*
Number of Dependants*
Dependants ages(if applicable)*
Residential Address*
Postal Code*
Time Period (Years / Months)*    
Residential Status*
Previous details required only if duration at current address is less than 3 years
Previous Address
Postal Code
Time Period (Years / Months)    
Residential Status

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  • Secured or unsecured personal loans
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  • Personal loans available from $1000 to $40000
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  • Loans for any worth while purpose

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