Loan Amount Tenor 1 month2 months3 months4 months5 months6 months7 months8 months9 months10 months11 months12 months Purpose of the Loan Source of Income for Repayment Profits from BusinessInterest Income from InvestmentsSalarySale of AssetsTrade ReceivablesProceeds from Contract PaymentOther Collateral Car (4-Wheel Drive)Car (Saloon Car)Land (with Indenture)Land (Registered at Lands Commission)Building (Residential)Building (Commercial)Investments (T-Bills, Bonds, etc.)OtherI don't have collateral Proprietor's Name Telephone Number Email Address I have reviewed the Tariff Guide and the Guarantors/Collateral Policy. I acknowledge that YieldRock has the right to decline my loan request if I am found to be ineligible. I accept