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Loan Application Form

warningThis Loan Application Form is only available for loan size up to US$ 30,000.

1. Loan Applicant (Individual)
Name
Gender Female
Male
Date of Birth
No. ID. Card/Family Book/Others
Address
Marital status Single
Married
Widow/Widower
Phone
Email
Occupation/Business Employment
Business
Place
And
• Name
• Gender Female
Male
• Date of Birth
• No. ID. Card/Family Book/Others
• Relationship Wife
Husband
Others
 
Next
2. Financial Status (Monthly Cash Flow)
3. Monthly Repayment Capacity
4. Collateral
5. Loan Requirement
We hereby declare that all information provided is clear and correct.
We would like to sign and stamp or offix thumbprint as evident.

Date:..........................................
Sign and Stamp or thumbprint of loan applicant




Name:......................................................

Do you want QR Code (KHQR) or POS for your business?

Please fill our form here and we will contact you and prepare these payment facilities for you. You can request ACLEDA Bank's QR code (KHQR) or POS terminal for your business.

Apply Now

The bank in your hand! 3.71M people using this.

For complaint purpose (every working day from 7:30 to 16:30).

phone015 888 654
emailcmc@acledabank.com.kh

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