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APPLY FOR LINE OF CREDIT LETTER
Loan Application Form
Nyali Capital
>
Loan Application Form
Fill all the Details Below
All fields marked * are mandatory
Personal Details
Name of Entity:
Entity registration number / Incorporation number:
Applicant Name:
*
National ID/Passport No:
*
Marital Status:
*
Single
Married
Widowed
Divorced
Directorship
Director
Not Director
No. of shares the applicant has in the company:
Date of Birth:
*
Postal Address with postal code (Current):
*
Mobile:
*
Email Address:
*
Number of Children
*
Name of School children attend:
*
Number of children attending School
*
Any candidate this year?
*
Yes
No
Which Exam?
KCPE
KCSE
Location Details
Town:
*
Estate:
*
Ownership
*
Rented
Owner
House Number:
LR No:
Rent per Month (Kes without commas)
Office Location
*
Office Phone Number
*
Previous Office Location
*
Spouse Details
Name of Spouse
Spouse Phone Number
*
Spouse ID Number
*
Spouse Profession
*
Name & Phone Number of employer, if spouse is employed
Next of Kin Details
Name of Next of Kin
Next of Kin Phone Number
*
Next of Kin ID Number
*
Next of Kin Profession
*
Name & Phone Number of employer, if Next of Kin is employed
Particulars of Owners of the Business
Name of Director 1
*
ID Number
*
Email Address
*
Phone Number
*
Name of Director 2
ID Number
Email Address
Phone Number
Name of Director 3
ID Number
Email Address
Phone Number
Are you a member of any sacco?
*
Yes
No
Number of months in operation:
*
Monthly turnover sales(KES): (without comma)
*
Amount of Debtors(KES): (without comma)
*
Amount of Creditors(KES): (without comma)
*
Other liabilities e.g. loans/overdraft:
Do the employees of your organization belong to any Sacco?
*
Yes
No
If No, would you like us to register them with Ecobiz Sacco?
*
Yes
No
Later
Contact person Phone Number:
Financial Institution
*
Type of Account
*
Balance as at Date of Application
Loan Particulars
Amount applied (KES)(without commas)
*
Repayment Period in years
*
Purpose
*
Guarantors
Name of Guarantor 1
*
Relationship
*
ID Number
*
Phone Number
*
Profession
*
If employed, Name and Phone Number of Employer
*
Date Today
*
Name of Guarantor 2
Relationship
ID Number
Phone Number
Profession
If employed, Name and Phone Number of Employer
Date Today
*
Security/Collateral and Referees
Name of Referee 1
*
Relationship
*
Phone Number
*
Email Address
*
Name of Referee 2
Relationship
Phone Number
Email Address
Name of Referee 3
Relationship
Phone Number
Email Address
Security Type 1
*
Details
*
Value(KES)
*
Security Type 2
Details
Value(KES)
Required Documents
Passport size photo
*
Choose File
No file chosen
Delete uploaded file
Company Profile
*
Choose File
No file chosen
Delete uploaded file
Certificate of Incorporation
*
Choose File
No file chosen
Delete uploaded file
Bank statement( six Months)
*
Choose File
No file chosen
Delete uploaded file
MPESA Statement (six Month)
*
Choose File
No file chosen
Delete uploaded file
License or Business Permit
*
Choose File
No file chosen
Delete uploaded file
Credit Report
*
Choose File
No file chosen
Delete uploaded file
Personal KRA Pin
*
Choose File
No file chosen
Delete uploaded file
Pay slips ( salary Loan only)
*
Choose File
No file chosen
Delete uploaded file
ID Copy
*
Choose File
No file chosen
Delete uploaded file
Business KRA Pin
*
Choose File
No file chosen
Delete uploaded file
Proposed Security
*
Choose File
No file chosen
Delete uploaded file
LPO Document
*
Choose File
No file chosen
Delete uploaded file
Tax Compliance
*
Choose File
No file chosen
Delete uploaded file
Date Today
*
We the undersigned declares that the information provided including attachments to this application are correct. We are aware that as part of loan appraisal Nyali capital is at liberty to verify and collaborate the information. Compliance with documentation requirements including opening of collection account is not a guarantee of approval of the loan applied.
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