::: LAGOS STATE CIVIL SERVANT LOAN :::

APPLICANT INFORMATION

LAGOS STATE CIVIL SERVANTS
BVN *
Account Name

Prefix Surname First Name Other Name
Date Of Birth *

Month Day Year
Date
Gender *
Marital Status *
Home Address *
Phone *
Means of Identification *
Nationality
State of Origin *
Local Government Area (Lagos State) *
Local Government Area (Abia State) *
Local Government Area (Adamawa State) *
Local Government Area (Akwa Ibom State) *
Local Government Area (Anambra State) *
Local Government Area (Bauchi State) *
Local Government Area (Bayelsa State) *
Local Government Area (Benue State) *
Local Government Area (Borno State) *
Local Government Area (Cross River State) *
Local Government Area (Delta State) *
Local Government Area (Ebonyi State) *
Local Government Area (Edo State) *
Local Government Area (Ekiti State) *
Local Government Area (Enugu State) *
Local Government Area (FCT State) *
Local Government Area (Gombe State) *
Local Government Area (Imo State) *
Local Government Area (Jigawa State) *
Local Government Area (Kaduna State) *
Local Government Area (Kano State) *
Local Government Area (Katsina State) *
Local Government Area (Kebbi State) *
Local Government Area (Kogi State) *
Local Government Area (Kwara State) *
Local Government Area (Nasarawa State) *
Local Government Area (Niger State) *
Local Government Area (Ogun State) *
Local Government Area (Ondo State) *
Local Government Area (Osun State) *
Local Government Area (Oyo State) *
Local Government Area (Plateau State) *
Local Government Area (Rivers State) *
Local Government Area (Sokoto State) *
Local Government Area (Taraba State) *
Local Government Area (Yobe State) *
Local Government Area (Zamfara State) *
Email Address (Optional)
example@example.com
Occupation *
Mother's Maiden Name *
Designation *
Customer house description (KYC) *
Land Mark *
EMPLOYMENT INFORMATION
Employer's Name *
Employer's Address *
Length of Service *
Mobile Number *
Oracle ID Number *
Tax ID number (Optional)
Date of Employment *

Month Day Year
Date
Date of Confirmation *

Month Day Year
Date
Department *
Grade/Level *
Annual Income *
Net Monthly Income *
Bank Name (Salary Account) *
Account Number *
Account Type *
NEXT OF KIN
Name *

First Name Last Name
Address (Next of Kin) *
Relationship *
Phone *
LOAN DETAILS
Loan Amount Required *
Tenor *
OTHER LOANS, DEBTS OR OBLIGATIONS

Name of Bank or Institution

Principal Amount

Outstanding Balance

Monthly Payment

Documents to be uploaded
1. Valid ID (Drivers License, Voters Card, International Passport)
2. Staff ID Card
3. Statement of Account (3 Month recent)
4. 3 Month Payslip (Recent)
5. Confirmation & Appointment Letter or Promotion Letter
6. Specimen Signature
7. 1 Passport Photograph
Upload Documents

Browse Files
Upload Multiple document at the same time Cancel of
Account Officer's Name
Account Officer's Email Address
example@example.com
How did you hear about us?
Today's Date

Month Day Year
Date
For Official Use only
Account Number:..............................................................................................................
Account Officers Name:..............................................................................................................
Head, Business Development:...........................................................................................................................
Head, Credit & Risk Mgt:..............................................................................................................
Internal Control:..............................................................................................................
Head, FINCON:.....................................................................................................................
Approve by:.....................................................................................................................
Should be Empty:

APPLICANT INFORMATION

EMPLOYMENT INFORMATION

NEXT OF KIN

LOAN DETAILS

OTHER LOANS, DEBTS OR OBLIGATIONS