Loan Application Form

DISCLAIMER: Do not pay cash to any staff or agent!

ConsumerMFB will not accept liability for cash transaction to any staff

Fields marked with an * are required

First Name *

Last Name *

Other Name

Phone No *

Salary Account Number *

IPPIS NO *

Salary Bank *

BVN *

Marital Status *

Married
Single
Divorced

Date of Birth *

Home Address *

Gender *

MDA(Your Office) *

State of Origin *

LGA of Origin *

Divider Copy

Loan Amount *

Tenure *

Account Officer *

Divider

Next of Kin Name *

Relationship *

Next of Kin Phone No *

Next of Kin Address *

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