PACEPANE Nigeria - Loan Application

person Personal Information

Title:

Mr.

Mrs.

Miss

Dr.

Prof.

Surname:

First Name:

Middle Name:

Date of Birth:

Gender:

Male

Female

Marital Status:

Single

Married

Divorced

Widowed

Phone Number:

Alternate Phone Number:

Personal Email Address:

Residential Address:

City:

State:

Local Government Area (LGA):

Name of Next of Kin:

Relationship with Next of Kin:

Next of Kin's Phone Number:

work Employment & Verification Details

Ministry/Department/Agency (MDA):

Official State of Posting:

Specific Office Address:

Employee ID Number:

Date of First Appointment:

Current Grade Level:

Current Step:

Current Salary (Gross Monthly):

Official Phone Number (Office):

BVN (Bank Verification Number):

NIN (National Identity Number):

request_quote Loan Request Details

Requested Loan Amount (₦):

Loan Tenor (Repayment Period):

6 Months

12 Months

Purpose of Loan:

Detailed List of Food Items:

Name of Bank:

Bank Account Number:

Account Name:

assignment Additional Information

Have you ever benefited from a PACEPANE loan before?

Yes

No

If yes, please provide details:

Do you have any existing loans with other financial institutions?

Yes

No

If yes, please state the institution and outstanding balance:

checklist Review Your Application

Application Summary

Name: -

Employee ID: -

Loan Amount: -

Loan Tenor: -

Purpose: -

I hereby certify that all the information provided in this form is true and correct.

I authorize PACEPANE to verify my employment and financial details with my MDA.

I understand that this loan will be repaid via direct deduction from my salary at source and authorize my employer to do so.

Applicant's Signature:

Date:

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Application Submitted Successfully!

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