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+234-01 453 9080
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192A, Jide Oki Street,
Victoria Island, Lagos,
08:00 am – 04:00 pm
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Home
About Us
Vision and Mission
Our Core Values
Our Directors
Our Management Team
Our Logo
FAQs
Products
Mortgage Products
Brent Mortgage Direct
Brent Diaspora Mortgage
Brent NHF
Brent Commercial Mortgage
Brent Rent To Own
Banking Products
Brent Premium Account
Brent Home Enhancement
Brent Kiddies Account
Brent Salary Advance
Brent Target Account
Services
eBanking
Mobile App
Transfer Form
Open an Account
Open an Account
Dormant Account Reactivation
Apply for Loan
Loan Questionaire Form – Nigeria Based Applicants
Loan Questionaire Form – Diaspora Based Applicant
Brent Micro Mortgage Loan Application
Brent Salary Advance
Brent Mortgage Loan Application
Projects Financed
Mortgage Calculator
Contact Us
Privacy Policy
Terms and Conditions
Admin Portal
LOAN QUESTIONAIRE FORM – NIGERIA BASED APPLICANTS
LOAN QUESTIONAIRE FORM - NIGERIA BASED APPLICANTS
Step 1 of 5
20%
APPLICANT
Individual
Joint
Joint Applicant should jointly complete the space provided
Applicant Details
Name
First
Last
Name 2
First
Last
Applicant: Date of Birth:
Date Format: MM slash DD slash YYYY
Gender:
Male
Female
Gender:
Male
Female
Mobile number:
Marital Status
Single
Married
Divorced
Number of Dependant
Address:
Country of Residence
State of Residence
Email
State(s) of Origin:
Applicant BVN NO
Tax Identification Number
Account(s) detail
Account Number
Current Balance:=N=
Date Account Opened
Date Format: MM slash DD slash YYYY
Employment & Income details
Employment Type
Salaried
Commission Based
Self employed
Others
Applicant Occupation
If employed, Name of Employer
Address of Employer:
Can you be contacted there?
Yes
No
Telephone:
Years of Service (with Current Employers):
Description of the industry that applicant(s) works
Working Experience in the industry
Monthly Gross Pay
Monthly Net Pay
Other Allowances:=N=
( these includes benefits, bonuses and other emoluments required to be paid by your employer either monthly, quarterly, semiannually and annually e.t.c and the frequency must be stated below appropriately)
Average Allowance: N
Frequency:
Loan request& Guarantors
Proposed Loan Amount=N
(i.e Principal amount applicant requires from the bank to buy proposed property)
Purpose of Loan
Proposed Loan Tenure
(i.e repayment period)
Proposed Interest Rate
Security in Place
Proposed Guarantors
Full Name
Address
Targeted Property
Description of the Property
Title Document on Property
( e.g C of O, Deed of Assignment and Deed of Conveyance with Governor Consent etc)
Location of the Property
Proposed equity Payment %
(i.e Down payment expressed as a percentage)
Other information
Are you currently on any facility (Loan) ?
If Yes, Please state the following; a. Loan Balance
Monthly Repayment
Remaining number of years to repay
Cost of the Property=N=
( i.e purchase price of the property which equals loan amount plus equity)
Part Payment( if any):=N
Location of the Property
Declaration: I/We certify that the above information provided by me for the purpose of profiling and pre-qualification is true.
Upload Signature
Date
Date Format: MM slash DD slash YYYY
Upload Signature
Date
Date Format: MM slash DD slash YYYY
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