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Loan Account No. |
| Applicant's Name | |
| NRIC/FIN No. |
| Next of Kin's Particulars | |
|---|---|
| Full Name | |
| Contact Number | |
| Relationship with Applicant | |
| Declaration: | |||||||
| 1. I hereby declare that all information given above is true and correct. | |||||||
| 2. I hereby consent and authorise 1 Fullerton Credit Pte Ltd to contact my Next of Kin above if I failed to make repayment promptly as per payment schedule. |
| __________________ |
| Applicant's Signature |
| Date: |