Loan Application Request Form
First Name
*
Please First Name is invalid try to remove space in your First Name.
Middle Name
*
Please Middle Name is invalid or try to remove space in your Middle Name.
SurName
*
Please SurName is invalid or try to remove space in your SurName.
Gender
*
--Select Sex--
Male
Female
Marital Status
*
--Select Marital--
Single
Married
Nationality
*
--Select--
Tanzanian
Foreign
Phone Number
*
Please Phone Number is required.
Guarantor Name / Jina la Mdhamini
*
Guarantor Phone / Namba ya Mdhamini
*
Email address
*
Resident Address/Current Location
*
Please Address is required
Customer Attachnment
Upload Your Passport Size
*
Upload Trustee Passport Size
*
Attach Vote ID/Driver License ID for Customer (
PDF ONLY
)
*
Attach Vote ID/Driver License ID for Trustee (
PDF ONLY
)
*
Identification letter from the local government (
PDF ONLY
)
*
Customer Bank Details
Bank Name
Bank Account Number
Loan Amount
Office Location
*
--Select Office Location--
BOMA
CHEKERENI
KAHE
MABOGINI
MAILISITA
MARANGU
MOSHI TOWN
MWANGA
NJIAPANDA
ROMBO MASHATI
SANYA JUU
TARAKEA
Kikundi
*
--Select Kikundi--
Before submitting:
choose whether you are a new customer or you have been registered with Mane Mane before.
Submit as New Customer
Submit as Existing Customer