LOAN APPLICATION FORM First name* Last name* Address* Phone Number:* Email* Is your business registered by CAC? YesNo If "yes", state the type of entity registered: EnterpriseCooperativeLimited Liability Amount of investment sought. ₦ Describe the product(s) / service(s) provided by the business: Do you have a business plan? YesNo Does your business have the requisite regulatory certification(s)/license(s) for the product(s)/service(s) (If applicable)? YesNo Please indicate your area of deployment of the anticipated capital injection: Plant & MachineryUtilities (Generator, Transformer, etc.)Working Capital (Raw Materials/ Consumables)Defray/Off-Setting Existing LoansOthers If others please specify Do you have collateral for the expected capital injection? YesNo All submitted information and documentation will be subject to plagiarism & verification checks Δ Click to download blank PDF Form If you are handwriting your responses, please email the completed form to: Funding@PlateauStateDiaspora.org