Quickinvest Limited Hardelec House, 2nd Floor
+265 888 57 59 77
+265 995 08 62 85
info@quickinvestmw.com
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Debt Agreement Form
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BORROWERS DETAILS
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Checkboxes
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Mr
Mrs
Miss
Dr
Rev
Prof.
Checkboxes
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Male
Female
Marital Status
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Married
Single
Divorced
Widowed
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Name
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First
Middle
Last
Date of Birth
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Purpose of Borrowing
Agriculture
Business
Education
Furniture & Construction
Consumption
Other uses
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Mobile Number
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Tel
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Email
*
Postal Adress
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Next
ID
*
National ID
ID Number
*
Date of Issue
*
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Expiry Date:
*
Copy of National ID
*
Next
Debt Amount (MWK
*
Repayment Date:
*
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Repayment period
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Amount in Words
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Proposed Collaterals
*
Next
Checkboxes
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Mobile Money
Bank Transfer
Bank Name
Account Name
Account Number
Mobile Number
*
Branch Name
Next
Name
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First
Last
I have read the declarations & agree to the terms and conditions
*
I declare that the above information is true to the best of my knowledge. I understand that if any of the information I
have provided proves to be false after disbursement and failure to repay the debt Microplace Limited has the right to call back the debt immediately. I consent
to Microplace Limited, in connection with my debt, making such enquiries about my affair as it seems fit and failure to service the debt shall entail forfeiture
of declared collateral/security to Microplace Limited.
Submit