International Digital deposit AiTiMart Loan Application
To apply for a loan, please complete all sections of this form. Please provide the photos of your
government issued personal ID along with the driver's license with this application.
Section One – Personal Details
Title
First Name/s
Surname
National Ins. Number
Date of Birth / /
Marital Status
Number of Dependents
Ages of Dependents
Residency Status UK Citizen EU Citizen Non-EU Citizen
Section Two – Address Details
Current Address
Postcode
Date Moved to Address / /
Residential Status
Home Owner Private Tenant Council / HA Tenant
Living with Parents Shared Accommodation
If you have been at your current address for less than three years, please provide your previous
address. If you have lived at more than two addresses in the last three years please provide additional
addresses on a separate piece of paper.
Previous Address
Postcode
Date Moved to Address / /
Section Three – Contact Details
Please provide at least one phone number and your e-mail address if you have one. If you provide a
mobile number, we can send you text messages with information on the progress of your application.
We will also send you an e-mail confirming the final decision on your application.
Home Tel No
Mobile Tel No
Email Address
Section Four – Employment Details
If you are not currently employed, please proceed to the next section.
Employment Status
Job Title
Current Employer
Address
Postcode
Work Tel No (including extension if applicable)
Employment Status
Full Time Part Time Self Employed
Type of Contract
Permanent Temporary Fixed Term
Contract Expiry Date / / (if applicable)
Date Joined Employer / /
Section Five – Loan Details
Amount Requested USD
Purpose of Loan
Please explain your need fully. If your loan request is to cover multiple items, please describe them
and provide an estimate of the cost for each.
Section Six – Income and Expenditure
Total Monthly Income USD
Rent / Mortgage Cost USD
Household Bills USD
Other Regular Expenses USD
Section Six – Additional Information
Is there any other information regarding your application that you would like to tell us about?
Section Seven – Using Your Information
Your information may be processed by us in any form and on any database used by us for the
following purposes:
to consider any applications made by you;
to deal with your account(s) or run any other services we provide to you;
to undertake statistical analysis, money laundering checks (which may include telephoning you),
compliance and regulatory reporting, and fraud prevention.
Section Eight– Declaration
I declare to the best of my knowledge and belief, that:
1. I am / am not in good health and I am fit / not fit to follow my normal occupation. (Delete as
applicable)
2. I authorise the International Digital deposit AiTiMart to obtain any further information as required
from my employer or credit reference agency.
3. All statements contained in this application are complete and accurate to the best of my knowledge
and belief and I acknowledge that if any information given in this application proves incomplete or
inaccurate, any loan to me as a result of this application may become immediately repayable to the
International Digital deposit AiTiMart .
4. I understand that the provision of false information is fraud and that the International Digital
deposit AiTiMart may take appropriate action if I am found to have deliberately provided false or
misleading information.
5. I understand that in the event of the loss of my income / employment due to an accident,
redundancy, or sickness, I will still be required to make my agreed loan repayments.
Applicant’s Signature ………………………………………………………… Date Signed ……….. /……… /………..
