Salary Advance Loan Application Form

LOAN PRODUCT DETAILS:
• Interest Rate: 8% | Maximum: Up to 33.3% of net salary | Term: 1-3 months
• Processing Time: 18 hours or less | Disbursement: Within 24 hours

1. APPLICANT INFORMATION

Full Name *

Date of Birth *

Email Address *

Phone Number *

Residential Address *

2. IDENTIFICATION

ID Type *

ID Number *

Date of Issue *

Expiration Date *

3. EMPLOYMENT INFORMATION

Employer Name *

Position/Job Title *

Employment Status *

Years with Current Employer *

Monthly Salary (LRD) *

Payment Method *

4. LOAN REQUEST DETAILS

Loan Amount Needed (LRD) *

Repayment Term *

Loan Purpose *

Expected Repayment Start Date *

Expected Repayment End Date *

5. REQUIRED DOCUMENTS

Document	Required	Notes
Proof of Current Salary (Recent payslip)	✓ Yes	Last 1-2 months
Valid ID Card (Photo Copy)	✓ Yes	Passport/License/National ID
Employment Verification Letter	Optional	From employer
Bank Statement	Optional	Last 3 months

6. REPAYMENT SCHEDULE PREFERENCE

Expected Repayment Start Date *

Preferred Deduction Method *

7. CONSENT & DECLARATION

I confirm that all information provided is accurate and complete. I authorize PassMark MicroFinance Hub to verify my employment and salary information. I understand and accept the interest rate (8%) and repayment terms. I agree to repay the loan according to the agreed schedule. I have read and understood all terms and conditions of this loan agreement.

Applicant Signature

Date (DD/MM/YYYY)

7. EMPLOYER VERIFICATION

Employer Name:

Employer Signature:

Date (DD/MM/YYYY):

PASSMARK MICROFINANCE HUB