Sugarcane Farmers Special Loan Facility


APPLICATION FORM
TYPE OF BUSINESS

Sole Trader        Partnership        Company        Cooperative       
Required Field

DETAILS
Courtesy Title First Name Surname Date of Birth
Required Field
Required Field
Please leave blank if not applicable
Required Field Format
Gender Residential Address Province Nationality
Required Field
Please leave blank if not applicable
Required Field
Required Field
Postal Address Name of Business Business Location
Please leave blank if not applicable
Required Field
Required Field
TIN /Reference Number
(Please provide your TIN if you are applying for this Facility for the first time. If this is a subsequent loan, please enter the previous Reference Number (e.g., SFRP1111111))
Please provide your TIN if you are applying for this Facility for the first time. If this is a subsequent loan, please enter the previous Reference Number (e.g., SFRP1111111).
Home Phone Mobile Number Business Contact Email
Please leave blank if not applicable
Required Field
Required Field
FNPF Number Driving License Number Nearest Branch Marital Status
Please enter valid FNPF Number or leave blank
Please leave blank if not applicable
Required Field
Required Field
Spouse Name Spouse Contact Number of Dependents Age of Dependents
Please leave blank if not applicable
Please leave blank if not applicable
Required Field
Please leave blank if not applicable
Current Occupation Educational Attainment Income
Required Field
Required Field
$0,- $5,000        $5,001- $10,000        $10,001- $20,000        $20,001- $30,000        $30,001- $50,000        $50,001+        Required Field
BANK DETAILS
Bank Account Name Bank Account Number Bank Name
Required Field
Required Field
DISABILITY
Are you living with any form of disability?

(Disclaimer: Please note that FDB will only share statistical data with the Reserve Bank of Fiji. FDB does not discriminate against any form of disability)

Required Field
LOAN DETAILS
Loan Type Loan Classification
New Customer        Further Loan (FDB Existing Customer)       
Agriculture
Loan amount sought from Fiji Development Bank Provide brief details (Short Paragraph) on the Purpose of loan
Required Field

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DECLARATION












UPLOADS
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(A loan decision will not be made unless these documents are uploaded here.)

DISCLOSURE

The Applicant’s attention is drawn to Section 41 of the Fiji Development Act [Cap 214] Ordinance 1966 which reads;

“If you willfully fail to disclose any material information within your knowledge, or willfully make any statement which you know
to be false or does not believe to be true, for the purposes of securing a loan from, or any investment in any form by, or assistance
in any form or any facility from the Bank, you shall be guilty of an offence and on conviction shall be liable to a fine not exceeding
one thousand dollars or to imprisonment for a term not exceeding two years, or to both such fine and imprisonment”.

   I/We certify that the information contained in this application and in all continuation sheets attached is true, accurate and complete in every particular. You are authorized herewith to request any information you may require regarding my/our accounts and financial arrangements with my/our Bankers or other financial Institution or my/our creditors.
Required Field


The Fiji Development Bank (FDB) does not collect personal information for commercial marketing or distribution to any
private organizations, except for reporting with the Reserve Bank of Fiji.