murabaha application form3
TRANSCRIPT
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MURABAHA APPLICATION FORM
Affix Your
Passport Size
Photo Here
Application Date: ………./……./201…….
Application fee TZSs………………….… Paid (see section 8)
Receipt number ………………
Type of facility …………………………………
Section 1: Applicant’s particulars and contacts
Applicant’s Name: First _ Surname
Nationality
Place of birth
Your telephone numbers 1)
2)
Gender (F/M): Date of Birth Marital Status: married Y/N
Spouses’ name: his/her Mobile No. _
P. O. BOX Residence location _
Description of residence location: _
E-mail Address
Your house is owned or rented: _ Number of Dependents:
Next of Kin’s name:
Relationship: _ Tel no. _
Do you have an outstanding Loan (Y/N) _________
Which bank__________________outstanding amount
(TZ)_______________Maturity date__________________
Who referred you to us (full name):
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JabalNur Islamic Finance Loan Application Form version 1.0 2014
Section 2: Your Business Profile (for business and group Loan)
Name of the company: _
Type of the business:
_
_
Registration Date _ Registration Number: _
Telephone/Mobile:
Experience in Business: years.
Number of workers employed: Ownership
Who are your Customers _
Who are your Suppliers are:
Your monthly turn over (TZSs.)
Section 3: Financing Requirement (Details )
Amount applied TZS
Purpose: (please provide details)
_
_
_
_____________________________________________________________________________________________________________________________
Section 4: Documents Application Requirements: Put “V” against the available items
Item v Item v
Employment ID Collateral
Voter’s Registration Card Business licenses
Passport Size Photo Letter from local government
Bank statement Reference letter from your bank
Financial statements Business visitation done?
Vendor’s Invoice Application fee paid?
Letter from Guarantor Comments about the requirements(if any)
Section 5: Applicant Declaration
I attest that the details provided above are true and correct, and by my signature below I authorize
the obtaining of any references from other places which may seem beneficial to the company.
Applicant Name: _Signature:
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JabalNur Islamic Finance Loan Application Form version 1.0 2014
Section 7: For official use only
7.1 To be completed by JabalNur officer
Type of loan Date Site/Office/Home visited
Factor
Obtainable Score
Total score
Credit Officer’s Comments
Character
30
Capacity
20
Capital
20
Condition
10
Collateral
10
Common sense
10
Total
100
JNF Officer’s Comments:
I recommend for approval/not recommended for approval (delete one)
Name: Signature: _ Date:
7.2 To be completed by MD
Operations Manager’s Comments: _
_____
I approve/not approve (delete one)
Name: Signature: Date:
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JabalNur Islamic Finance Loan Application Form version 1.0 2014
Section 8: Application Am ount and Fee Structure
No
Min. (TZS) Max.
(Max.)
Application Fee in
TZS
1
300,000.00
500,000.00
20,000