Wealthplus Investment Pvt Ltd
Business Reg No: PV-00241512
Office: 328/2, Kirillawala, Imbulgoda, Kadawatha, Sri Lanka

PERSONAL LOAN REQUEST FORM

Required Documents:
- Copy of NIC / Driving License / Passport.
- Last 3 months payslips.
- Bank statements (last 6 months).

---
SECTION A: APPLICANT INFORMATION
Full Name: __________________________________________________
NIC Number: ___________________ Occupation: __________________
Monthly Net Income: LKR _________ Net Take-home: LKR __________

SECTION B: FINANCING DETAILS
Requested Loan Amount: LKR ____________ Period (Months): _____
Purpose of Loan: ____________________________________________

SECTION C: GUARANTOR DETAILS
Guarantor Full Name: ________________________________________
Guarantor NIC: _________________ Contact No: ________________

Applicant Signature: ______________________ Date: ______________