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Loan Amount (UGX)
*
Purpose of Loan
*
Business
Personal
LPO Financing
Construction
Medical Care
Others
Gender
*
Male
Female
Employment Gender Income
First Name
*
Last Name
*
Email
Mobile Phone
*
Date of Birth
*
Marital Status
*
Choose Option
Married
Single
Co-Habiting
Separated
Divoced
Widowed
Number of Dependants
*
Country
*
District
*
Town
*
Home Owner Status
*
Renting
Owner / Landlord
Employment Status
*
Full Time Employee
Part Time Employee
Self Employed
Unemployed
Retired
Pension
Employer Name
Length of Employment
*
Security
*
eg; laptops, car, motorcycle, land title logbook, mobile phone etc.
Estimated value of security (UGX)
*
Monthly Income (UGX)
*
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