Kapeni house 1st floor
Victoria Avenue
8:00 AM to 5:00 PM
Monday to Friday
+(265) 881 112 265
info@nyasacapital.com
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General Application Form
General Application Form
1. APPLICANT’S PERSONAL DETAILS
Mbiri ya munthu amene akufuna kutenga ngongole
Full Name (Name and Surname)
*
Dzina lanu ndi la bambo
Tel & Cell Number
*
Nambala ya foni yanu
Email Address
Keyala yolandilira ma kalata pa intaneti
ID. Type
*
Passport
ID Card
Other
ID. Type
Ntumdu wa chiphaso chanu
ID. Number
*
Nambala ya chiphaso chanu
Home address
*
Kumudzi Kochokera
Physical address
Kumene Mukukhala
End Section
2. EMPLOYMENT/ BUSINESS DETAILS
Mbiri ya kampane imene mukugwira kapena bizinesi yanu
Name of Employer/ Business
Dzina la kumene mukugwira ntchito/Bizinesi Yanu
Occupation (State if Self-employed)
Ntchito yomwe mukugwira (Tiziwitseni ngati mumazigwilira ntchito nokha)
Address of Employer/Business
Dela la kutchito kwanu/Bizinesi Yanu
Telephone Number
Telefoni nambala
Fax Number
Nambala yotumizira telegalamu
Monthly Income (Expected)
Ndalama zimene mupeza pamwezi (Zimene mukuyembekezera kupeza)
Additional Fund Source (if applicable)
Ntchulani kumene ndalama zina zowonjezera mumazipeza (Ngati mumapeza zowonjezera)
Email or HR Head
keyala yolandilira makalata pa intaneti ya munthu woyang’anira anthu olembedwa ntchito
Frequency of Funds Received
Daily
Weekly
Fortnightly
Monthly
Mumalandira motani
Nature of Business Activity
Nenani zimene bizinesi yanu imapanga
End Section
3. INFORMATION OF YOUR BANKER (S)
Mbiri yakumene kuli buku lanu losungira ndalama
ACCOUNT NAME
Dzina la buku lanu
BANK AND BRANCH
Banki lanu ndi nthambi ya kumene kuli buku lanu
ACCOUNT NUMBER
Nambala ya buku lanu
ACCOUNT TYPE
Cheque
Savings
Other
Other
Ntundu wa buku lanu
End Section
5. PRODUCT TYPE AND AMOUNT
PRODUCT OR SERVICES REQUIRED
Education loan
Employer supported loan
Project financing
Order financing
Group Loans
Other
PRODUCT OR SERVICES REQUIRED
Ngongole yomwe mukufuna kutenga
LOAN AMOUNT
Ngongole yake ndi zingati
End Section
6. WITNESS/GUARANTOR/REFEREE
Mboni
Full Name
Dzina lanu ndi la bambo
Nationality
Dziko lochokera
Contact Number
Nambala ya lamya
ID. Type
*
Passport
ID Card
Other
ID. Type
Ntumdu wa chiphaso chanu
ID Number
Nambala yachiphaso
End Section
7. DECLARATION
APPLICANT’S DECLARATION
*
I/W (Name Above) declare that the above information is accurate to the best of my knowledge
Date
*
WITNESS/GUARANTOR/REFEREE DECLARATION
*
I/WE(Above name) certify that applicant above is an active/staff/business person of the (institution and unit/branch/department). I/WE also certify that his/her employment/business details given above are accurate to the best of my knowledge
Date
*
End Section
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