AttonBank Loan Application
To apply for a loan, please complete all sections of this form. Please provide the photos of
your
Government issued personal ID along with the driver's license with this application.
Section One – Personal Details
Title SIR
First Name/s BROU
Surname KOUAME ARMAND
Nat Ins. Number C0028640934
Date of Birth 23/12/1989
Marital Status SINGLE
Number of Dependents 02
Ages of Dependents 01 YEAR and 12 YEARS
Residency Status UK Citizen EU Citizen Non-EU Citizen
Section Two – Address Details
Current Address ABIDJAN,COCODY
Postcode 20 BP 86 ABIDJAN 20
Date Moved to Address 01/01 /2007
Residential Status Home Owner Private Tenant Council / HA
Tenantӿ
Living with Parents Shared Accommodation
If you have been at your current address for less than three years, please provide your
previous address. If you have lived at more than two addresses in the last three years please
provide additional addresses on a separate piece of paper.
Previous Address
Postcode ………………………………
Date Moved to Address ……….. /……… /………..
If you have had more than two addresses in the last three years, please provide us with all
further details in the Additional Information section of this form, or on a separate piece of
paper.
Section Three – Contact Details
Please provide at least one phone number and your e-mail address if you have one. If you
provide a mobile number,
×We can send you text messages with information on the progress of your application. We
will also send you an e-mail confirming the final decision on your application.
Home Tel No ………………………………………………………
Mobile Tel No 00225 01626446
Email Address armandbroukouame@gmail.com
Section Four – Employment Details
If you are not currently employed, please proceed to the next section.
Employment Status …………………………………………………………………………………………
Current Employer …………………………………………………………………………………………
Address ……………………………………………………………………………………………
…………………………………………………………………………………………………
Postcode ………………………………
Work Tel No ……………………………………… (including extension if applicable)
Job Title ………………………………………………………………………………………………
Employment Status Full Time Part Time Self Employed
Type of Contract Permanent Temporary Fixed Term
Contract Expiry Date ……….. /……… /……….. (if applicable)
Date Joined Employer ……….. /……… /………..
Section Five – Loan Details
Amount Requested USD 2000
Purpose of Loan
This loan of USD 2000 aims to diversify my investments and make more profit, the borrowed
money will allow me to buy crypto currency mining contracts at the cost of USD 500, it will
also allow me to invest USD700 on a trading platform and lass time USD 645 to support the
medical expenses of my one year old daughter.
Please explain your need fully. If your loan request is to cover multiple items, please itemize
Them and provide an estimate of the cost for each.
Section Six – Income and Expenditure
Total Monthly Income USD 500
Rent / Mortgage Cost USD 230
Household Bills USD 120
Other Regular Expenses USD 100
Section Six – Additional Information
Is there any other information regarding your application that you would like to tell us
about?
Most of my income comes from crypto currency mining, purchase of mining contract and
trading platform.
Section Seven – Using Your Information
Your information may be processed by us in any form and on any database used by us for
the following purposes:
To consider any applications made by you;
To deal with your account(s) or run any other services we provide to you;
To undertake statistical analysis, money laundering checks (which may include telephoning
you), compliance and regulatory reporting, and fraud prevention;
Section Eight– Declaration
I declare to the best of my knowledge and belief, that:
1. I am in good health and I am fit to follow my normal occupation. (Delete as applicable)
2. I authorize the AttonBank to obtain any further information as required from my
employer or credit reference agency.
3. All statements contained in this application are complete and accurate to the best of my
knowledge and belief and I acknowledge that if any information given in this application
proves incomplete or inaccurate, any loan to me as a result of this application may become
immediately repayable to the AttonBank.
4. I understand that the provision of false information is fraud and that the AttonBank may
take appropriate action if I am found to have deliberately provided false or misleading
information.
5. I understand that in the event of the loss of my income / employment due to an accident,
redundancy, or sickness, I will still be required to make my agreed loan repayments.
Applicant’s Signature Armand Date Signed 07 /05/2020
