Online Loan Application Form
Application Date
Loan Amount Requested*
No. of Loans with Others
Active Loans (s)
Full Name*
Identity Document Type*
NRIC/FIN*
Date of Birth*
Nationality*
Gender*
Martial Status*
Email*
Phone*
Additional Phones
Home Phone
Ownership of Property
Property Type
Residence Address*
Company Name
Company Registration Number
Company Address
Company Phone
Position/Title
Employment Period
Salary Date
Monthly Salary*
Annual Income
NOK Name
Relationship
NOK Contact No

I hereby declare that the above information provided by me are true and accurate to the best of my knowledge.


I have been informed that the information collated are used for credit management, assessment and debt recovery purposes. A misrepresentation or omission of facts required will be a sufficient cause for rejection.