Loan Application Form

Full Name (Khmer)

Full Name (English)

Date of Birth

Phone Number

Occupation

Current Address

Loan Amount ($)

Loan Term

Currency

Loan Purpose

Drag & drop your files here or click to browse. Max 5MB per file.

Upload Selfie Photo

Upload National ID (Front)

Upload National ID (Back)

Upload Bank Statement (Last 3 Months)

កម្មវិធីស្នើសុំប្រាក់កម្ចី