PERSONAL INFORMATION AND STATEMENT OF NETWORTH Affix a
recent
OF INDIVIDUAL GUARANTOR coloured
(To be completed by the Guarantor in Block Letters) passport
photo here
SECTION A: GUARANTOR’S PERSONAL DATA
FULL NAME:……………………………………………………………………………………………..
RESIDENTIAL ADDRESS: ………………………………………………………………………………
……………………………………………………………………………………………………………
OCCUPATION/PROFESSION: ……………………………………………………………………….
NAME OF EMPLOYER: ………………………………………………………………………………..
JOB POSITION/TITLE: …………………………………………………………………………………
GRADE LEVEL: ………………………………………………………………………………………...
DATE OF FIRST APPOINTMENT: ……………………………………………………………………...
LENGTH OF SERVICE: ……………………………………………………………………..................
YEAR OF RETIREMENT (if applicable): …………………………………………………................
OFFICE/BUSINESS ADDRESS:…………………………………………………………………………
……………………………………………………………………………………………………………
AGE: ……………. PERSONAL TEL. NO (GSM): ……………………………………………………
OFFICE/BUSINESS TEL NO: ……………………………… BVN: …………………………...………
MARITAL STATUS: ……………………. NEXT OF KIN: ……………………………………………
PLACE OF ORIGIN: …………………………LGA:……………………………………………….
EDUCATIONAL QUALIFICATIONS: ……………………..…………….……………………………
NAME OF INSTITUTION(S) ATTENDED: …………………………………………………………….
……………………………………………………………………………………………………………
SECTION B: GUARANTOR’S STATEMENT OF PERSONAL NET WORTH
ASSETS*
(Landed properties, moveable and
S/N LOCATION VALUE (#)
personal assets, quoted shares/stocks,
cash deposit in banks etc.)
TOTAL ASSETS VALUE
S/N LIABILITIES* TO WHOM VALUE (#)
1 Loan(s)/Cash
2 Mortgages
3 Lease/Rents
4 Investment
5 Bills/Utilities
6 Taxes
7 Other Debts/Miscellaneous etc.
TOTAL LIABILITIES
* Please furnish the details on the attached details list
NET WORTH (i.e. TOTAL ASSETS less TOTAL LIABILITIES) N…………………………
(…………………………………………………………………………………………………………
…………………………………………………………………………………..……… Naira Only)
I hereby confirm that all the information provided in this Form as at the date stated herein are
true and accurate and that the Bank of Industry Limited may rely on same for assessing my net
worth for the purpose of my Personal Guarantee.
SIGNATURE: ……………………..………………….. DATE: …………………………..……..........