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FUNDHILL MICRO-FINANCE

MULTIPURPOSE CO-OPERATIVE SOCIETY LTD


#10T Rukuba Road Jos, Plateau State GUARANTOR’S
08113815671
PASSPORT
GUARANTOR FORM

BORROWER’S DATA

NAME: ………………………………………………………………………………………………………………………………………………………

RC NO: ………………………………………………………………………………………………………………………………………………………

RESIDENTIAL ADDRESS: …………………………………………………………………………………………………………………………….

AMOUNT BEING GUARANTEED: ……………………………………………………………………………………………………………….

GUARANTOR’S DATA

SURNAME: ……………………………………………OTHER NAME: …………………………………………………………………………..

RESIDENTIAL ADDRESS: …………………………………………………………………………………………………………………………….

RENTED/OWENED: …………TELEPHONE NO: ……………………………….EMAIL: ………………………………………………….

PLACE OF WORK WITH ADDRESS: ……………………………………………………………………………………………………………..

PERMANENT HOME ADDRESS: ………………………………………………………………………………………………………………….

PLACE OF WORSHIP: …………………………………………………………………………………………………………………………………

NEXT OF KIN: …………………………………………………..PHONE NO: …………………………………………………………………….

ANY ACCOUNT WITH LAWYERS MFB (YES/NO) IF YES ACCOUNT NUMBER: ……………………………………………..

RELATIONSHIP WITH CUSTOMER: …………………………………………………………………………………………………………….

DECLARATION
I hereby certify/ confirm that I know the above person/company and consider him/she/it /fit and proper
to access your banking loans/facility. I am also aware that he/she/ it has applied for a loan/facility of
N………………. and do hereby surety/indemnify/guarantee your bank to the tune of N ……………….in case
the customer fails to repay the amount borrowed or any outstanding upon maturity of the facility. I
agree to pay back the outstanding balance in case the above customer fails to offset the loan.

GUARANTOR’S SIGNATURE: ………………………………………………DATE: ...............................................................