HEAD OFFICE
13 Barbados Avenue, Kingston 5, Jamaica, W.I.
Tel: (876)- 926-2669/ 754-4112
Fax: (876)- 960-2519
First Union Financial Company

In Service to the Employees and Entrepreneurs of Jamaica.

Branches: Branches: Montego Bay, Ocho Rios, Mandeville, Westmoreland, May Pen, Portland, Spanish Town, Linstead, Spanish Town Road, Ocean Boulevard

Application/ Review Date:  
Dbl Borrowing Checked:
Branch:  
Account Status:  
Credit Score:  
1. PERSONAL INFORMATION
NAME OF BORROWER (SURNAME. FIRSTNAME. MIDDLE INITIAL)  
AGE  
DOB
[ dd/mm/yyyy ]
TRN  
TELEPHONE
[ xxx-xxx-xxxx ]
 
PRESENT HOME ADDRESS:
 
OWN RENT OTHER:
YEARS:
MAILING ADRESS:
 
NUMBER OF DEPENDENTS:  
PREVIOUS HOME ADDRESS:
 
YEARS:
MARITAL STATUS:  
EMAIL:  
NAME & ADRESS OF TWO RELATIVES NOT LIVING WITH YOU
NAME: NAME:
ADDRESS: ADDRESS:
RELATIONSHIP: RELATIONSHIP:
TEL: TEL:
TRN: TRN:

NIS: NIS:
2 BUSINESS INFORMATION
NAME:
YEARS:    
TELEPHONE:    
E-MAIL:    
BUSINESS ADDRESS:
 
BUSINESS MAILING ADDRESS:
 
TRN FOR BUSINESS:
BUSINESS ACTIVITY:
TELEPHONE:  
REGISTRATION NUMBER
DATE OF INCORPORATION/REGISTRATION  
GCT NUMBER
TCC NUMBER  
NAME & ADRESS OF OTHER DIRECTORS OR PARTNERS
NAME: NAME:
ADDRESS: ADDRESS:
RELATIONSHIP: RELATIONSHIP:
TEL: TEL:
TRN: TRN:
3. LOAN DETAILS
PURPOSE OF LOAN:  
   
LOAN AMOUNT :  
BUSINESS EQUITY:  
FULL COST: $  
DESCRIPTION OF SECURITY  
 
VALUE  
NAME OF VALUATOR  
DATE  
ASSETS
DEPOSIT ACC# FINANCIAL INSTITUTION BRANCH ACC. TYPE ACCOUNT BAL
4. INCOME & EXPEDITURE STATEMENT
Gross Monthly Income: Amounts owing: Cash in Hand:
Less Deduction at Source: Banks: Bank Balances:
Net Income(TAKE HOME PAY): Credit Card: Balance / Finish:
Other Income: Hire Purchase: Receivables:
TOTAL INCOME Goods on Credit Inventory
CAR LOAN PAYMENT Taxes-Income, Other Stocks and Shares
Hire Purchase Agreements Other Amounts Owed CSV-Life Policies
Life Insurance Premiums Sub Total Other liquid Assets
Other Loan Payments     Sub Total
Rents     Investments
Mortgage, Maintenance Long Term Debts Furniture
Insurance- Home, Vehicle Mortgage Loans Motor vehicles
Transportation Expenses Other Loans Equipment/ Machinery
Utilities Total Liabilities Real Estate
Living Expenses-Food Clothing etc Surplus Other Assets
Educational Expenses-School Fees Total  $ Total  $
Medical, Dental, Optical  
Entertainment  
Other  
Total Expenses  
Surplus/Deficit  
Applied Interest rate: Recording Stamping & Registration Fee: Total Fees: $
Processing Fee: Other Fees:    
5. REFEREES
NAME: NAME:
TRN: TRN:
ADDRESS: ADDRESS:
TEL: TEL:
EMPLOYER NAME: EMPLOYER NAME:
OCCUPATION: OCCUPATION:
EMPLOYER ADDRESS: EMPLOYER ADDRESS:
TEL: TEL:
REFEREES
NAME: NAME:
TRN: TRN:
HOME ADDRESS: HOME ADDRESS:
EMPLOYERS NAME: EMPLOYERS NAME:
OCCUPATION: OCCUPATION:
EMPLOYER ADDRESS: EMPLOYER ADDRESS:
TEL: TEL:
6. GUARANTOR
NAME (SURNAME. FIRSTNAME. MIDDLE INITIAL)
AGE:  
DOB:  
TRN:  
PRESENT HOME ADDRESS:  
 
OWN/ RENT/ OTHER:
YEAR:
   
MAILING ADRESS:
 
# OF DEPENDENTS:  
MARITAL STATUS:  
PREVIOUS HOME ADDRESS:    
YEARS:  
EMAIL:  
NAME & ADRESS OF TWO RELATIVES NOT LIVING WITH YOU
NAME: NAME:
ADDRESS: ADDRESS:
RELATIONSHIP: RELATIONSHIP:
TEL: TEL:
TRN: TRN:
Reference By:  
Employer
Work Address:
Home Address:
TRN:
6. CUSTOMERS DECLARATION
I( )  apply for a loan of $   and confirm that the information given is true in all respects, accurate and complete and that I have not withheld any information that might affect First Union Financial  decision. I agree to First Union taking such steps as may deem necessary to verify any of the information given. I agree to pay your customary charge of 2.5% on due amounts for any overdue installments.  You are authorized to provide information to credit bureaus and other credit grantors as permitted by law. I agree to pay all fees associated with the processing of the loan.
Click to accept the above terms