1. Full Name *
2. Nationality KenyanOther
3. If Nationality Other (Please specify)
4. Marital Status SingleMarriedDivorced
5. National ID No. / Passport No *
6. Pin No. *
7. Postal Address *
8. Postal Code *
9. Town *
10. PF. No. *
11. Date of Birth *
12. Country KenayTanzania
13. Telephone / Mobile No. *
14. Physical / Residential Address *
15. Email Address *

* Required

1. Name *
2. Relationship *
3. Postal Address *
4. Postal Code *
5. Town *
6. Country *
7. Telephone / Mobile No. *
8. Email Address

1. Job Title *
2. Date of Employment *
3. Recruitment Date *
4. Contract Expiry Date *
5. Employment Type PermanentContractOther
6. If Employment Type Other (Please specify)

1. Full Name *
2. Postal Address *
3. Telephone / Mobile No. *
4. Physical Address *

1. Gross Salary *
2. Net Salary *

1. Account Name *
2. Bank Name *
3. Branch *
4. Account Number *
5. Preferred Mode of Payment EFTChequeOther
6. If Other Mode of Payment (Please Specify)

1. Loan Amount *
2. Purpose for Loan *
3. Repayment Period (months) *

1. Full Name *
2. Organisation *
3. Postal Address *
4. Telephone (office) *
5. Mobile No. *
6. Full Name *
7. Organisation *
8. Posatl Address *
9. Telephone (office) *
10. Mobile No *

1. Bank / Financial Institution
2. Original Amount
3. Present Balance
4. Monthly Installment

1. Bank / Financial Institution
2. Original Amount
3. Present Balance
4. Monthly Installment

1. Bank / Financial Institution
2. Original Amount
3. Present Balance
4. Monthly Installment

1. Bank / Financial Institution
2. Original Amount
3. Present Balance
4. Monthly Installment

1. Bank / Financial Institution
2. Original Amount
3. Present Balance
4. Monthly Installment

1. Are you currently active at work? YesNo
2. Do you suffer or have ever suffered any ailment, disease, disorder or disability that would affect the decision of African Capital Ltd to process this loan application? YesNo
3. If yes, give details

I warrant that the information disclosed by me in this application form is correct in every respect and I hereby authorize and give my consent to African Capital Limited to make any enquirers necessary from time to time to verify the information in my loan application. I understand that African Capital Limited may decline my loan application or may decide to grant me a loan of a lesser amount. I warrant that I have read, understand and shall apply the terms and conditions governing the loan, and agree to be bound by them.

1. Applicants Name *
2. Date *

1. Passport Size Photograph *
2. 3 Latest original pay slips *
3. Copy of National Id *
4. Copy of ATM Card *
5. Introduction Letter (For TSC Employee Only)

6. By submitting this form, you have read and accept the terms and conditions below:

   Terms and conditions