Application for Coverage Loan
(Please complete the form in CAPITAL letter)

To
The Manager
Bank Asia Limited

Dear Sir,
With a view to enjoying consumer credit facility from your bank I am hereby placing necessary informations for pre-assesment :

1. Full Name :
2. Father's Name :
3. Mother's Name :
4. Applicant's Date of birth : (dd) (mm) (yyyy)
5. Age : [years]
6. Gender :Male Female
7. Marital Status :Married Unmarried
8. Name of the spouse :
9. Banking practice [any bank] : [years]
10. Per month income / salary : [take-home]
11. Per month expance :
12. Monthly Surplus Income :
13. Total service period/business length : year(s)
14. Applicant's designation :
15. Name of the Employer/Organization :
16. Nature of Business :
17. Having any account with Bank Asia? : Yes No
18. Account number :
19. Coverage loan type :
20. Amount of Loan :
21. Number of Years :
22. Installment amount per month :
23. Through my relationship : Saving, STD, CD, FDR, WageEarners
  accounts are maintaining with your branch.
 
The above information is authentic and has the evidence of proof.
 
Thanking you,
 

Signature of Applicants