LOAN APPLICATION FORM
 

 
Application for   Block Discounting
    Floor Stocking

 
 
   
 
  COMPANY PROFILE
 
  Company’s Name
  Business Address
   
   
  Registered Address
   
   
  Telephone Number
  Office Premises
Own
Renting (Rental Amount : RM  )
 
 
  MANAGEMENT PROFILE
 
 
Name Designation Age Years of
Experience		 Qualification Duties
 
 
  STAFF STRENGTH
 
 
Department No of staff
Executive Clerk
  1. Marketing
  2. Sales
  3. Administration
  4. Credit Control
  5.
      Total
 
 
  FACILITIES WITH OTHER FINANCIERS/BANKERS
 
 
Financiers/Bankers Branch Type of
Facility		 Limit Amount
Utilisation
as at		 Security
 
   
 
   
 
  PERSONAL DATA
 
  Name
  Sex
Male
Female
  Date of Birth
  Age
  NRIC No
  Nationality
Malaysian
Others 
  Race
Malay
Chinese
Indian
Others 
  Tel. No. (House)
  Tel. No. (Office)
  Handphone No.
  Home Address
   
   
 
 
  WORKING EXPERIENCE
 
 
Company Designation Years of
Service		 Duties
 
 
  STATEMENT OF PERSONAL AFFAIRS
 
 
ASSETS
Type Value Particulars
  Land
  Building/ House
  Business Investment
  Savings
  Others
LIABILITIES
Type Banker Amount Approved Balance Outstanding
@
  Housing Loan
  Hire Purchase
  Credit Card
  Others