FDB Loan for Women Entrepreneurs


APPLICATION FORM
TYPE OF BUSINESS

Sole Trader        Partnership        Joint Ventures        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 TIN
Please leave blank if not applicable
Required Field
Required Field
Required Field Maximum 12 Characters
Home Phone Mobile Number Business Contact Email
Please leave blank if not applicable
Required Field
Required Field
Required Field Please check if there is a space at the end of the email address
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/MyCash/M-PAiSA Name Bank Account/MyCash/M-PAiSA 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
JOINT APPLICANT
JOINT APPLICANT 1 DETAILS
Courtesy Title First Name Surname Date of Birth
Gender Residential Address Province Nationality
Postal Address Name of Business Business Location TIN
Maximum 12 Characters
Home Phone Mobile Number Business Contact Email
Please Enter Number
Please Enter Number
Please Enter Number
FNPF Number Driving License Number Marital Status
Please Enter Number
Please Enter Number
Spouse Name Spouse Contact Number of Dependents Age of Dependents
Please Enter Number
Current Occupation Educational Attainment Income
$0,- $5,000
$5,001- $10,000
$10,001- $20,000
$20,001- $30,000
$30,001- $50,000
$50,001+ Required Field
APPLICANT 1 BANK DETAILS
Bank Account Name Bank Account Number Bank Name
APPLLICANT 1 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)

LOAN DETAILS
Loan Type Loan Classification
New Customer        Further Loan (FDB Existing Customer)       
Business
Loan amount sought from Fiji Development Bank Provide brief details (Short Paragraph) on the Purpose of loan
Required Field, minimum amount is $1,000 and maximum amount is $5,000
Brief background of Business
Required Field
OTHER BORROWING
Financial Institution Loan Balance ($) Monthly Repayments
Required Field
Numbers only
Numbers only
Required Field
Numbers only
Numbers only
Required Field
Numbers only
Numbers only
Required Field
Numbers only
Numbers only
Required Field
Numbers only
Numbers only
UPLOADS

(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 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”.

FIJI DEVELOPMENT BANK

PLEASE READ THIS CAREFULLY BEFORE SUBMITTING THE FORM.
BY CLICKING SUBMIT YOU ARE AGREEING TO THE FOLLOWING:

    I/We certify that the information contained in this application and in all continuation tabs and attachments is true, accurate and complete in every particular.
Required Field
    I/We authorize FDB staff to view my/our personal details for the purpose of loan appraisal.
Required Field
    I/We authorise FDB to obtain credit and/or other related checks that may be required regarding my/our accounts and financial arrangements from my/our Bankers or other Financial Institutions or my/our Creditor or other search platforms.
Required Field
    I/We authorize FDB to conduct credit checks on Credit Information Reporting Agency (CIRA).
Required Field
    I/We authorize FDB to share my/our details with the Reserve Bank of Fiji for the purpose of reporting.
Required Field
    I/We have read and understood the General Terms and Conditions of the FDB Loans for Women Entrepreneurs specified under www.fdb.com.fj and agree to abide by the terms and conditions.
Required Field
    By submitting this loan application and if successful, my/our subsequent acceptance of the loan offer together with the funds disbursed to me/us by FDB, is an absolute confirmation of my/our acceptance of the terms, charges and conditions outlined in Schedule 3 Acknowledgement of FDB’s Rights on Default, Schedule 4 Acknowledgement of Financial Advice, Schedule 5 Statement of Declaration and Authority by Borrower(s), Schedule 6 Acceptance Note, Schedule 7 Surety Acceptance Note and the Fees and Charges (if applicable).
Required Field
UNDERTAKING
    I/We, hereby undertake to fully repay the loan advanced to me/us by the Fiji Development Bank under FDB Loans for Women Entrepreneurs together with all interest payable for the purpose of loan and its associated terms and conditions mention under www.fdb.com.fj
Required Field
    I/We are aware that FDB shall retain the right to undertake legal recovery and enforcement proceedings against me/us if we fail to honour this undertaking Required Field
    I/We agree that all legal costs associated with pursuing a breach of the Undertaking will be borne by me/us on an indemnity basis.
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.