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Name *

First

Last

Phone *

Email *

Age *

Nationality *

National Identification Number *

Place of Residence *

Village *

Division *

City *

Country of Residence *

Number of children *

Employment Details *

Name of Business/ Company/ Organisation

Position

City *

Country *

Monthly income/ Salary *

Loan request (State amount required & currency) *

Purpose (Reason for borrowing) *

Loan Term e.g No. of days, months, years *

Do you have collateral/ security if required *

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

Do you have an existing loan? *

If yes, how much and for what purpose? *

Name of Lender

Remaining balance

How did you know about us? LinkedIn, X, TikTok, Instagram, Investimo, Google, 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 the INVESTIMO General Terms and Conditions