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Personal Information

 

Title

*First name

*Family name

*Father’s name

Mother’s full maiden name

*E-mail

Education

Place of birth

Date of birth

Register number

Nationality

Register Place

Gender

Education

Marital status

Spouse’s full maiden name

No. of children

Age of children

No. of dependants (if any)

 

Home Address

 

Bldg. name

Floor no.

Street

City

*Tel

*Mobile

Apartment is

 

 

 

Banking Relationships

 

Accounts

 

Name of bank

Name of bank

Branch

Branch.

Type of account

Type of account

Current Loans Borrowed

 

Type of loan

Amount borrowed
(in US Dollars)

Remaining amount
(in US Dollars)

Monthly loan payment
(in US Dollars)

Are you a personal loan guarantor?

 

 

Bank

Branch

 

Employment

 

Status

 

 

Company / employer name

Company / employer phone no.

Time spent at company (in years)

Employer’s Bank(s) / Branch(es)

 

Account Request

 

Account type

 

 

Name of Joint Account Holder (If any)

Relationship between Applicants

Currency

 

 

Amount of account

 

 

Deposit Period (for Time Deposit Account only)

 

 

At which FRANSABANK branch

 

 

How did you know about the account?

 

 

 



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