AGSMEIS LOAN APPLICATION FORM

(PLEASE FILL IN LETTER)

Personal Details
Name of Applicant: Gender

Home Address:

State of Origin: State of Residence Delta Age

Phone Number Email Address

Name of Bank Bank Account Number

BVN
Business Details
Name of Business

Business Address

Company Acct No. Name of Bank

Type of Business Sector

Start Up Years of operation

Loan Utilization
Loan Amount Purpose Tenor
Provide details of Required Equipment Type/Model (e.g Industrial Sewing Machine/Model 345 EML)
1 Amount

2 Amount

3 Amount

4 Amount

5 Amount

Provide Details of Working Capital Requirements Total

1 Amount

2 Amount

3 Amount

4 Amount

5 Amount

Source of Repayment SALES Total

Loan Utilization
Training Institution Training ID
Type of Training Duration
Comments