Date: D D M M Y Y Y Y
From: ........................................................................................................................................ (Applicant Name and Address)
..........................................................................................
Tel: ...................................................................................
To: GCB Bank Limited (GCB Branch Name and Address)
...........................................................................
...........................................................................
DEAR SIR/MADAM,
APPLICATION FOR A PERSONAL LOAN
I wish to apply for personal loan of GH¢ ............................................................................................................................
....................................................................................................................................................................................................
(Ghana Cedis) for the purpose of .........................................................................................................................................
....................................................................................................................................................................................................
against my account number ..................................................................................................................................................
with .................................................................................................................................................. branch.
I wish to repay the said loan within an installment period of .........................................................
months/years.
I have also attached all the required documents for your review.
Yours faithfully,
.......................................................................
(Name and Signature)
GCB Bank Limited
Personal Loan Application Form your bank for life
General Information (Complete in block letters and tick where applicable)
Transaction Branch: Date: D D M M Y Y Y Y
Loan Number: (official use only)
Account Details
Account Number: Account Branch:
Account Name:
Personal Details
Title: Dr. Mr. Miss. Mrs. Other
First Name:
Middle Name:
Last Name:
Maiden Name:
(If applicable)
Country of Birth:
Date of Birth: D D M M Y Y Y Y Age: Place of Birth:
Gender: Male Female
Tax Identification No. Social Security No.
Educational Level: Basic Secondary Diploma/Certificate Undergraduate
Post Graduate Not literate
Marital Status Single Married Divorced Separated Widowed
Nationality: Religion:
Residential Status: Resident in Ghana Non-Resident No. of Dependents:
Mother’s Maiden Name:
Type of Residence: Owned Family House Rented Others (specify)
Name of Employer:
Existing Bank Relationship? Yes No
Can we contact you in future? Yes No
If yes, please indicate by what means Call SMS Email
Address Details
Postal Address:
Residential Address:
Landmark:
Country: State/Region:
District: Town/City:
Digital Address: Email:
Mobile No.1: Mobile No. 2:
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your bank for life
Occupancy Since: D D M M Y Y Y Y
If Rented, Landlord Details
Name of Landlord: Mobile No.:
Rent Amount:
Frequency of Rent: Monthly Quarterly Half yearly Yearly
Product Details
Product: Personal Loan Pension Loan Easy Pick Others
Loan Amount Requested: Tenure (months):
Monthly Net Income:
Monthly Current Obligations:
Purpose of Loan: Education Rent Advance Medical Home Renovation Funeral
Land Purchase Hire Purchase Car Purchase Others (specify)
Identification Details
ID Type: Voter’s ID Driver’s Licence National Security Service
SSNIT Biometric Passport Work Permit
ID No. Issue Date: D D M M Y Y Y Y Expiry Date: D D M M Y Y Y Y
Employment Details
Nature of Employment: Salaried Retired
Industry Sector:
Employment Type: Public Private Government Payroll No/Employee Id:
Occupation: Designation:
Department:
Employment Status: Full time Public Full time Private Retired Others
Date of Joining: D D M M Y Y Y Y Date of Retirement: D D M M Y Y Y Y
Employer Phone No.:
Direct Manager Name.:
Direct Manager Designation:
Direct Manager Phone No.:
Direct Manager Email:
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your bank for life
Employer’s Address Details
Postal Address:
Office Location:
Landmark:
Country: State/Region:
District: Town/City:
Digital Address: Email:
Mobile No.1: Mobile No. 2:
Income Details
Basic Income (Monthly Gross):
Other Income:
Total Deductions:
Total Net Monthly Income:
Financial Commitments (if applicable)
Name of Financial Institutions:
Product:
Account No.:
Loan Amount/Credit Limit:
Disbursement Date: D D M M Y Y Y Y Tenure (months):
Maturity Date: D D M M Y Y Y Y Installment Amount:
Outstanding Balance.: Defaulted: Yes No
Total Overdue/Arrears Amount:
Default Months:
NPA Classfication Status:
Collateral Type:
Next Due Date: D D M M Y Y Y Y Frequency:
Last Payment Amount:
Last Payment Date: D D M M Y Y Y Y
Facility Status: Remaining Tenure (Months):
Include in Eligibility Computation Value:
Currency: Finance Type:
Interest Rate %: Amount Considered:
Closed Date: D D M M Y Y Y Y Top Up Required? Yes No
Remarks:
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Contact Person’s Details
Title: Dr. Mr. Miss. Mrs. Other
Relation:
First Name:
Middle Name:
Last Name:
Gender: Male Female
Contact Person’s Address
Postal Address:
Residential Address:
Landmark:
Country: State/Region:
District: Town/City:
Digital Address: Email:
Mobile No.1: Mobile No. 2:
Years known:
Employer’s Undertaking Officer’s Details (1)
Title: Dr. Mr. Miss. Mrs. Other
First Name:
Middle Name:
Last Name:
Gender: Male Female
Designation:
Employer’s Undertaking Officer’s Address
Postal Address:
Office Location:
Landmark:
Country: State/Region:
District: Town/City:
Digital Address: Years known:
Mobile No.1: Email:
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your bank for life
Employer’s Undertaking Officer’s Details (2)
Title: Dr. Mr. Miss. Mrs. Other
First Name:
Middle Name:
Last Name:
Gender: Male Female
Designation:
Employer’s Undertaking Officer’s Address
Postal Address:
Office Location:
Landmark:
Country: State/Region:
District: Town/City:
Digital Address: Years known:
Mobile No.1: Email:
Jurat Clause (Applicable where the applicant is illiterate or blind and the form is read to him/her by a third party)
I agree to abide by the content of this Agreement and acknowledge that it has been truly and audibly read over
and or explained to me by a reader/interpreter. The language of interpretation is ……………..................................…….
Customer’s Name………………………………………………………...………......…………. Signature ……………………………………...........…….
Interpreter’s Name………………………………………………………...…….......……….. Signature………….............………………………………..
Adress of Reader/Interpreter………………………………………………………......................…………………………………………………………….
……………………………………………………………………………………….......................……… Mobile No…………………………………………………
Customer’s Instructions
I hereby irrevocably authorize you to debit my account with the monthly instalment of GHS……….. to the credit of
my loan account on the ……….. day of each month commencing on ………………….. and continue making such
payments until a total sum of GHS……………. (………………………………………………………………………) (excluding interest )
is paid. I hereby further declare that the Bank shall be entitled ( as well before as after demand) too set off my
liability under this loan against any credit balance in any account whatsoever in my name with the Bank or any
agent of the Bank if I default to pay the loan.
I, the undersigned, declare that the information provided above is my most current and accurate information.
I consent to the Bank making available information on the facility to the Central Data Bank of the Association of
Bankers and Credit Reference Bureaux and Agencies.
Customer Signature…………………………………………………………………………………… Date…………………………………
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your bank for life
From : To: The Chief Accountant
................................................................................................... ...................................................................................................
................................................................................................... ...................................................................................................
................................................................................................... ...................................................................................................
................................................................................................... ...................................................................................................
Dear Sir/Madam,
I am a customer of GCB Bank Ltd at .......................................................................................... Branch.
In consideration of the Bank agreeing to grant me a Personal Loan, I hereby authgorise you to pay my net monthly
salary while in the service of your establishment in to Account Number .................................................................................
with GCB Bank Ltd. .......................................................... Branch and with effect from ................... Day of ..............................
until the loan is paid off.
I also authorise you to pay all other entitlement, resignation, dismissal, vacation of post or incapacitation into
my account number ............................................................................. at the GCB Bank Ltd ..........................................................
Branch. I declare that you should also not put into effect any institutions given by me to the contrary unless such
request(s) is/are supported by a written confirmation/ consent fom the Bank that the loan has been paid off.
Yours faithfully,
..............................................................................
Customer’s Signature
EMPLOYER’S UNDERTAKING
The Manager
GCB Bank Ltd
.................................................................................. Branch
Dear Sir,
In consideration of GCB Bank Ltd agreeing to grant a Personal Loan to
Rev/Prof/Dr/Mr/Mrs/Miss ...................................................................................................................................... we
irrevocably undertake to carry out his/her foregoing instructions.
For the avoidance of doubt, we undertake.
1. To ensure that subject to any occasional administrative deductions, the net monthly salary remittable to
the Bank shall not fall below the present net salary of GHS.
2. To pay his/her pension and / or any other entitlements due him/her direct into his/her account with GCB Bank
Ltd. ................................................................... Branch.
3. To give due notice to the Bank within 14 days in the event of his/her vacation of post, transfer, dismissal,
resignation, death, retirement or incapacitation.
Yours faithfully,
Managing Director / Personal Or Human Resource Manager Chief Accountant / Financial Controller
Full Name (Block Letters) Full Name (Block Letters)
................................................................................................... ...............................................................................................
(Contact Tel. No(s)) ............................................................... (Contact Tel. No(s))............................................................
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your bank for life
FOR BANK USE ONLY
Data Input By :
Name ..................................................................................... Signature......................................... Date ..............................
Document Verification Carried Out By :
Name ..................................................................................... Signature......................................... Date ..............................
Loan Authorized/Approved By :
Name ..................................................................................... Signature......................................... Date ..............................
