Borrowers Data Form

This form should be completed in CAPITAL LETTERS

This form must be submitted along with a valid Government issued ID (International Passport or
Driver’s License)

SECTION A - PERSONAL DETAILS

# Mr.
# Mrs.
# Ms.
First Name: Middle Name:

Last Name: Marital Status- Married ☐ Single ☐ Divorced ☐ Other

Nationality: Date of Birth: Gender: ☐Male ☐Female

Passport No./Driver’s License No.: Mailing Address:

City: State: Zip/Post Code:

How long have you resided at this address? Own/Rent: Landline:

Mobile (1): Mobile (2): Fax:

Email: Best time to call: ☐Morning ☐Afternoon ☐Evening ☐Anytime

SECTION B - DETAILS OF LOAN

Amount Needed: Duration: Purpose of Loan:

SECTION C - EMPLOYMENT DETAILS

Status: Employed ☐ Self Employed ☐ Unemployed ☐ Retired ☐ Others

Nature of Business/Occupation:

Employer Name: Mailing Address:

City: State: Zip/Post Code:

Monthly Income: Yearly Income: Office Tel:

I/We have completed this request for credit in consideration of Equity Finance Ltd. lending to me and/or others upon
my guarantee. I/We certify that all information contained herein is accurate and complete to the best of my
knowledge.

Signature:

Date:

OFFICIAL USE ONLY

DOCUMENT
COMPLETED FORM Yes ☐ No ☐
PROOF OF IDENTITY Yes ☐ No ☐

APPLICATION CHECKED AND COMPLETE

Signature:

Name:

Date: