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Plot 3 Wole Olateju Crescent, Off Admiralty Way Lekki Phase 1 Nigeria
+(234) 9078689895
+(234) 9078689895

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Individual Loan Application

Step 1 of 6

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Personal Details
Name
Prefix First Middle Last
Date Of Birth
MM slash DD slash YYYY
Gender
- Male
- Female
Phone Number
Phone Number (Second)
Email
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Residential Status
- Rent
- Owner
- With Parents
- With Relative
- Others
Specify
Nationality
State Of Origin
LGA
Home town / Village
Means of ID
- International Passport
- National ID
- Drivers License
- Permanent Voters Card
ID Number
Issue Date
DD slash MM slash YYYY
Expiry Date
DD slash MM slash YYYY
MARITAL AND DEPENDANT DETAILS
- Married
- Single
- Others
No. of Children
Please enter a number from 1 to 20.
No. of Dependents
Please enter a number from 1 to 20.
Upload Passport Photograph*
Accepted file types: jpg, jpeg, png, Max. file size: 1 MB.

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NEXT OF KIN DETAILS
Name
Prefix First Middle Last
Gender
- Male
- Female
Date Of Birth
MM slash DD slash YYYY
Phone Number
Phone Number (Second)
Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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EMPLOYMENT STATUS
- Full time
- Part time
- Self Employed
- Temp Contract
- Retired
Employer/Business name
Employer/Business industry
Employer/Business Sector
- Public
- Private
Employer/Business Phone number
Employer/Business Email
Employer/Business Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business RC Number
Job/Business Start Date
MM slash DD slash YYYY
Job title/Position
Gross Monthly Income
Net Monthly Income

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LOAN DETAILS
Amount requested
Loan Purpose
Loan Tenure
Affordable monthly payment plan

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DISBURSEMENT DETAILS
*Please provide banking details should your application be successful*
Account name
Account number
BVN
Bank Name
Account Status
Date Opened
DD slash MM slash YYYY

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OTHER INFORMATION
Do you have an existing loan?
- Yes
- No
If yes, please specify
Name of Lender
Date Collected
MM slash DD slash YYYY
Type of credit
Balance due
Maturity Date
MM slash DD slash YYYY
ACKNOWLEDGEMENT*
I agreeto the terms attached to the submission of this application.
I/We hereby confirm my application for the above facility and certify that all information provided by me/us above
and attached there unto is/are correct and complete. I/We hereby declare that none of my/our assets, net worth, income or activities, now, in the past or in the future, relate in any way to money laundering or any other illegal activity.
Undertake to notify Glamshire Investments Limited of
any change of information or particulars provided by
me/us in this form.
I authorize you to further/any inquiry you consider
necessary and appropriate for the purpose of evaluating
this application.
Comments
This field is for validation purposes and should be left unchanged.

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Download Guarantor's form

Download the guarantor’s form that applies to your loan request type by clicking on the link below.

Guarantor's form

Apply for Business loan

You can opt for individual loan by clicking on the link below.

We make this belief a reality by putting clients first, leading with exceptional ideas, doing the right thing, and giving back.

Plot 3 Wole Olateju Crescent, Off Admiralty Way Lekki Phase 1 Nigeria

+44 7956971781
0700GLAMSHIRE

09078689895

info@glamshireinvestments.com

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