Students Loan Bureau

Statement of Affairs
Last Name

First Name

M.I

NAME

Guarantor TRN

Date of Birth

Day

Month

Home

Year

Sex

Male

Martial Status
Single/Divorced/
Widowed

Married

Female

Common Law

Separated

Work

Cell

Phone Number

E-Mail

Last Name

First Name

M.I

Name of
Spouse

Number of
Dependents

Guarantor's Relationship to applicant

Present
Address

How Long

year

months

Own/Rent

year

months

How Long

year

months

Own/Rent

year

months

How Long

year

months

Occupation/Position

How Long

year

months

Previous Employment

How Long

year

months

Name of Spouse's Place of

Employment

How Long

year

months

Occupation/Position of
spouse

How Long

year

months

Previous Address

Present Employment

Employment address

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Financial Statement as at ________/________/________

(Please complete the sections which apply to you)

Approximate Value J $
Assets

Liabilities

1. Do you currently have a savings account (s)? If yes,

please state the current balance and the institution (s) at
which the funds are being held.
*Name of Institution (s)

2. Are you the holder of any marketable security such as

stocks, bonds or any other financial instruments? If yes,
please state please state the value of same and the
institution (s) at which the funds are being held.
*stocks, bonds or any other financial instruments

Monthly
Payments
(Average)

Approximate Balance
Amount J $

1. Do you have any personal loan (s)

which you are currently repaying? If
yes, please state the amount currently
owing, the institution with which you
have said loan and the amount repaid
monthly.
*Name of Institution (s) and Purpose
for loan

2. Do you have a mortgage repaying?

If yes, please state the amount
currently owing, the institution with
which you have said loan and the
amount repaid monthly.

3. Do you own any property? If yes, please indicate the

address, the value and the name of the co-owner if the
property is jointly owned.
*Address & owner (s)

3. Have you rented the property in

which you reside or contribute to
monthly rental payment? If yes, please
state the amount paid each month.
Address

4. Are you in possession of a motor vehicle which is

registered in your name? If yes, please indicate the year,
model and value of same.
*Year & Model

4. Are you the holder of a credit card?

If yes, please state the maximum value
of same, the institution with which
you have said card and the amount
repaid monthly.
*Institution (s)

5. Kindly indicate the total value of furniture and

appliances own by you, if any.
*Appliances & Furniture

5. Kindly indicate the total value paid

on utilities
*(eg. Light, water, telephone, etc).

Total

Total

Surplus/Loss

I certify the above information to be true and correct. The undersigned consents to the obtaining of such information by the SLB from any credit reporting agency or other source as
the SLB may require at any time in connection with the credit hereby applied for and to the disclosure of any information concerning the undersigned to any credit reporting agency
or to any person with whom the undersigned has or proposes to have financial relations.

Date:

Signature:

______________________________

__________________________________________
Guarantor Signature

Witness:
____________________________________________
JP., Medical Practitioner, Attorney at law
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