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Name *

First

Last

and borrowing) Purpose

Phone *

Email *

Nationality *

Age *

Type of ID e.g. Government ID, Passport *

ID Number *

Expiry Date *

Place of residence *

Owned
Tennant

Village/ Zone *

Parish *

Division *

City *

Country of residence *

Number of children *

Employment details *

Self employed/ Entrepreneur
Employee
Civil/ Public servant

Name of Company/ Organization *

Position

Monthly income *

Village/ Zone where company/ organization/ business is located *

Division *

City *

Country *

Loan request (State amount and currency) *

Purpose (Reason for borrowing) *

Loan term/ Period E.g., No. of days, weeks, months, years *

Do you have Collateral/ Security (in case it is required) *

Would you like to be recommended to a Real Estate Agent? *

Do you have any existing loans? *

If yes, how much and for what purpose? *

Remaining balance *

How did you know about us? LinkedIn, X, Instagram, TikTok, Investimo, Facebook. Specify

Declaration *

I declare that the information provided is true and accurate. I consent to INVESTIMO verifying my information. I understand that I may be required to pay a non-refundable application fee and that INVESTIMO reserves the right to accept or refer or reject my application for further processing. BY SUBMITTING THIS FORM I AGREE TO BE BOUND BY THE INVESTIMO GENERAL TERMS AND CONDITIONS.

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