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Zenith Mortgage Loan Application Pre-Qualification Form
THIS MORTGAGE LOAN IS FINANCED BY ZENITH BANK PLC IN PARTNERSHIP WITH THE UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT (USAID).
*
Denotes required fields, Please follow the instruction in brackets "()" to complete the form appropriately
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Applicant Name:
(eg Surname, Firstname, othernames)
*
Sex:
Male
:
Female:
*
Marital Status:
Single:
Married:
Divorced:
Widowed:
Others:
*
Date of Birth:
(dd/mm/yyyy)
No. of Children:
(0 - 20)
*
Qualifications:
(Educational qualification eg: Bsc, Msc, etc)
*
Residential Address:
Home Phone:
(234-01-0000000)
*
GSM No:
(2348000000000)
*
Email:
No. of Dependants you are financially responsible for
(0 - 20)
*
Description of Property:
Price: (N)
(00.00)
*
Address of Property:
*
Proposed use:
Residence:
Investment:
*
Loan Amount Applied for:
(00.00)
*
Tenor:
(years)
*
Equity Contribution:
(00.00)
*
Mode of Principal Repayment:
Please select one:
Monthly
Quarterly
Half-Yearly
Yearly
Do you currently own a house?
Yes
No:
Outstanding Loan:
Institution
Value
Tenor
Security
*
Are You in:
Paid Employment:
Self Employed:
Last Employer:
Period of Employment
:
(in Months)
*
Current Employer:
Position:
*
Annual Gross Salary:
(00.00)
*
Estimated Monthly Expenses:
(00.00)
*
Estimated Terminal Benefit:
(00.00)
Zenith Bank Account Number:
(eg 6090110000)
Spouse Details
Name:
Profession:
Current Employer:
Gross Income:
(00.00)
I hereby confrim that I am applying for the above Mortgage load and certify that all the information provided by me above is true and complete and that I stand to be disqualified if found untrue. I hereby confirm that Zenith Bank Plc is authorised to obtain verification of the information provided in respect of my Mortgage loan application. And I understand and agree that the completion of this Loan Application Prequalification Form does not automatically guarantee the processing of my loan request or approval of a Mortgage loan by Zenith Bank Plc.
Accept