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APPLY FOR LOAN
Personal Information
Business Name
Company name/Employer's Name
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Last Name
your surname
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First Name
your name
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Other Name
your middle name
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Email
a valid email
email
Marital Status
pick one!
Select An Option
Single
Married
Divorced
No. of Children
pick one!
Select An Option
None
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2
3
4
5
More
Passport Photograph
upload
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Date of Birth
dd/mm/yyyy
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Office Telephone No.
Company's phone no
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Corporate Head Office Address
your full address
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Mobile Number
Your cell phone
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State of Origin
Choose your state
Select An Option
ABIA
ADAMAWA
AKWA IBOM
ANAMBRA
BAUCHI
BAYELSA
BENUE
BORNO
CROSS RIVER
DELTA
EBONYI
EDO
EKITI
ENUGU
GOMBE
IMO
JIGAWA
KADUNA
KANO
KATSINA
KEBBI
KOGI
KWARA
LAGOS
NASARAWA
NIGER
OGUN
ONDO
OSUN
OYO
PLATEAU
RIVERS
SOKOTO
TARABA
YOBE
ZAMFARA
FCT
Local Government Area
L.G.A
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Home Town
Your Village
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Residential Address
your full address
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Spouse/Next of kin Name
Full Name
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Spouse/Next of Kin Mobile No
Telephone Number
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Father’s full Name
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Mother’s full Name
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PROFESSIONAL INFORMATION
Job Position
pick one!
Select An Option
Self Employed
Trader
Civil Servant
Employed
Employment classification
pick one!
Select An Option
Junior staff
Senior staff
Management staff
Others
Name of current employer
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Address
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Years of service
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INCOME DETAILS: (Principal)
Annual Salary
Total Income Monthly
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ANNUAL TURN OVER
pick one!
Below N1m
N1m - N5m
N5m - N10m
N10m and above
Monthly allowance
If any
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ANY PREVIOUS APPLICATIONS
Do you have an existing loan?
Select An Option
Yes
No
PURPOSE OF LOAN
more details
0
/
500
PROPOSED TENURE
What is the duration of the loan?
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AMOUNT REQUESTED
In numbers
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BANK DETAILS
NAME OF ACCOUNT
your full name
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ACCOUNT NUMBER
NUBAN account number
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NAME OF BANK
pick one!
Select your Bank
Access Bank
Citibank
Diamond Bank
Ecobank Nigeria
Fidelity Bank Nigeria
First Bank of Nigeria
First City Monument Bank
Guaranty Trust Bank
Heritage Bank plc
Keystone Bank Limited
Providus Bank plc
Skye Bank
Stanbic IBTC Bank Nigeria Limited
Standard Chartered Bank
Sterling Bank
Suntrust Bank Nigeria Limited
Union Bank of Nigeria
United Bank for Africa
Unity Bank plc
Wema Bank
Zenith Bank
BANK VERIFICATION NUMBER (BVN)
BVN
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Bureau Mandate
we are mandated by the regulatory authorities to conduct a credit search from a Credit Bureau on your request and the cost shall be passed to you. Note also that EVERY information provided on this form shall be duly verified.
ATTESTATION
I certify that all the information provided by me above is true, correct and complete. I authorize you to make any enquiry you consider necessary and appropriate for the purpose of evaluating this application. (Please note that Quidcycle Capital reserves the right to charge management fee of 2.5%, monitoring fee of 2.5% upfront and an interest rate of 5% monthly upon disbursement. Repayment schedule is irrevocable and N10,000.00 and or 5% flat (which ever is higher) for any default returned cheque).
Default Penalty
Please note that we are mandated by the regulatory authorities to conduct a credit search from a Credit Bureau on your request and the cost shall be passed to you. Note also that EVERY information provided on this form shall be duly verified.
Approval
By submitting this form, you agree to all terms and conditions of our service.
Submit Form
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