Jebri Al Salem Financial Home

Address: Unit 7, Silverfield House, Claymore Drive, Aberdeen Energy Park. Bridge of Don, Aberdeen, AB21 8GD
Skype: jealsalfunds
Email: jealsalfunds@careceo.com

Loan Application Form

(Standard)
FOR OFFICIAL USE ONLY

1. Name of Applicant:
2. Full Address:

Date of application:

3. Loan Amount In Figure:

Loan Amount in Words:

4. Loan Amount Duration:

5. ID-number:

File handled by:

6. Place and Country of Birth:

Supporting documents:
7. Nationality:

8. Tel/Fax Number:

9. Sex
Male Female

10. Marital Status

Single Married Separated Divorced widowed
Other

11. Date of Birth (Year-Month-Day)

12. Purpose of Funding:

13.Type of Passport:
[ International Passport Diplomatic Passport Service Passport
[Aliens Passport rivers License Other travel document (please specify):
..
14. Passport Number

15. Issued By:

16. Date of Issue

17. Valid Until

18. If you reside in a country other than your origin, have you permission to travel outside the country?
No Yes
19. Current Occupation:

Validity
Invitation
Means of transport
Insurance
Other

Security: Refused
Granted

LTV
A
B
C
D
D+C

20.Employer Address and Telephone No:

Number of entries:
21. Next of Kin:

22. Tel/Fax No.:

1 2 Multiple

23. Address of Next of Kin:

24. Number of Request:

Single entry Two entries Multiple entries

25. Preferred Interest rate:

26. Any Outstanding Debts Yes No

Amount involved:

Purpose of debt:

i ..............................................................................................declare hereby that all the informations given in the Loan Application Form is
genuine and this funding firm will not be responsible for any mistakes caused me.