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 »  Loan Application Form

Loan Application Form

This Loan Application Form is only available for loan size up to US$ 30,000.

1. Loan Applicant (Individual)
Name
Gender Female    Male
Date of Birth (DD/MM/YYYY)
No. ID. Card/Family Book/Others
Address
Marital status Single    Married    Widow/Widower
Telephone
Email
Occupation/Business Employment    Business
Place
And
• Name
• Gender Female    Male
• Date of Birth (DD/MM/YYYY)
• No. ID. Card/Family Book/Others
• Relationship Wife    Husband     Others
 
Next
2. Financial Status (Monthly Cash Flow)
3. Monthly Repayment Capacity
4. Collateral
5. Loan Requirement
We hereby declare that all information provided is clear and correct.
We would like to sign and stamp or offix thumbprint as evident.

Date:..........................................
Sign and Stamp or thumbprint of loan applicant




Name:......................................................

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ACLEDA Bank Plc. Headquarters
Registration No. 00003077
#61, Preah Monivong Blvd., Sangkat Srah Chork,
Khan Daun Penh, Phnom Penh, Cambodia.
P.O. Box: 1149
Tel: +855 (0)23 998 777 / 430 999
Fax: +855 (0)23 430 555
E-mail: acledabank@acledabank.com.kh
SWIFT Code: ACLBKHPP
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