Cooperative Loan Form

Personal Details:

Title:

First Name:

Middle Name:

Surname:

Membership ID:

Loan Amount:

Guarantors Details 1:

First Name:

Middle Name:

Surname:

Residential Address:

Membership ID:

Personal Email Address:

Guarantor Phone Number:

Guarantor Details 2:

First Name:

Middle Name:

Surname:

Membership ID:

Loan:

Loan Type:

Official Pay Date:

Loan Amount:

Tenor Agreed:

Number of Cheques Submitted:

Six months Bank Statement:

Upload Other Document:

Reason for Loan:

(+234) 0703-326-4820

info@ibharcan.com

(+234) 0813-635-4251