Customer

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CUSTOMER DETAILS

PERSONAL DETAILS
Name:
Spouse Name
Father Name
Mother Name
DOB Gender Marital Status
Education Customer Category Religion
Residence Address

Landmark
City: State: ZIP Code:
Owned Rented Monthly payment or rent: How long? Proof
Residence Type Tel Rent
Permanent Address

Landmark
City State ZIP
Owned Rented Monthly payment or rent: How long? proof
Residence Type Tel Rent
Email Id Node pent
Gross Income Per Annum Citizenship
Residential Status
SPOUSE DETAILS
Name
DOB Occupation
Name of business

Monthly Income`
Details of facility required
Credit Facility Amount
Purpose of facility
Occupation Details`

Occupation Name
Employer Details Designation Cur Exp Tot Ex
Company Name ID
Address

City State Pin


landmark
Mobile Tel Ownership Email id

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CUSTOMER DETAILS
BANK DEATILS
Primary bank
Name of bank
A/c Number A/c type
REFERENCES
1.Reference Name
Address How long?

Land mark Relationship


Phone: E-mail: Fax:
City: State: ZIP Code:
2.Reference name
Address:

Phone: E-mail: Fax:


City: State: ZIP Code:

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