1. Applicant Information

Full Name (as per Emirates ID):

Nationality:

Date of Birth:

Gender:

MaleFemale

Marital Status:

SingleMarriedOther

Mobile Number: +971

Email Address:

2. Employment & Income Details

Company Name:

Designation:

Employment Type:

SalariedSelf-employed

Date of Joining:

Monthly Salary (AED):

Salary Transfer Bank:

3. Loan Details

Loan Amount Required (AED):

Loan Purpose:

PersonalEducationMedical

If Other:

Preferred Repayment Tenure:

12 Months24 Months36 Months48 Months

Any Existing Loans?

YesNo

If Yes, Total Monthly EMI (AED):

Current Loan Outstanding balance:

4. Documents Checklist

Emirates ID (Front & Back)Passport & Visa CopySalary Certificate / Pay Slips (Last 3 months)3 to 6 Months Bank StatementLabor Contract / Employment Letter (if required)

5. Declaration

I hereby declare that the information provided above is true and correct to the best of my knowledge. I authorize SELCTUS Financing Broker LLC to verify the information and share my details with UAE banks for processing this loan request.

Signature of Applicant:

Date: