Salary Advance Loan Application

PERSONAL AND OTHER DATA

Last name

Other names

Age

Marital status

Phone number

Address (Residential)

Nearest Bus-stop

Address (Work)

Nearest Bus-stop

Place of worship

Place of worship address

BVN

Email Address

Account Number

Position

Length of Service

Next of Kin

Address (Next of kin)

Phone number (Next of kin)

Relationship to next of kin

Next of kin home address

Passport

Current utility bill

Passport

FACILITY REQUIRED

Amount

Amount in words

Purpose

Upload

Document

CREDIT HISTORY

Have you ever borrowed from Rephidim Microfinance Bank Ltd.?

Amount Borrowed

Outstanding Balance

When

DECLARATION

I hereby confirm that the above information is correct to the best of my knowledge and authorize Rephidim Microfinance Bank Limited to make whatever inquiries it may deem fit for the purpose of this application.
I also confirm that the granting of this facility is not automatic but subject to a satisfactory assessment of Rephidim Microfinance Bank Ltd.

I agree.

Quick Loan Application is currently closed. Please visit our Office at 35, Osolo Way, Ajao Estate, Lagos.

Salary Advance Loan Application

Subscribe to our newsletter