Cooperative Finance Portal

COOPERATIVE

Financing, Liquidity & Capital Growth for Cooperative Societies & Associations

Cooperative Society / Entity Registration

Section 1 of 5

Cooperative Society / Organization Name * Please enter registered cooperative name

Registration Status *

Registration / Certificate Number * Please enter registration number

Year Established / Registered * Please enter valid year

Operating Location / State * Please select state

Cooperative Structure * Please select structure

Primary Sector / Member Activity * Please select sector

Society Secretariat / Physical Operating Address * Please provide physical address

President / Primary Executive Information

Section 2 of 5

Title

Full Legal Name * Please enter full legal name

Contact Mobile Phone *

+234

Please enter valid 10-11 digit phone number

Society / Office Phone *

+234

Please enter office phone

Official Email Address * Please enter a valid email

Residential Home Address of Primary Officer / Executive * Please provide residential address

Next of Kin (NOK) Information

Section 3 of 5

Next of Kin Full Name * Please provide next of kin name

Relationship * Please select relationship

Next of Kin Phone Number *

+234

Please enter next of kin phone

Next of Kin Residential Home Address * Please enter next of kin residential address

Cooperative Facility Request

Section 4 of 5

Requested Facility Amount (₦) *

₦

Minimum facility amount is ₦50,000

Preferred Repayment Tenor *

Primary Collateral / Security *

Collateral Description & Value Estimate * Please describe security / collateral

Purpose of Financing *

Citihoms Account Officer / Referral

Disbursal & Settlement Account Details

Section 5 of 5

Settlement Bank * Please select settlement bank

Society Account (NUBAN) * Enter valid 10-digit account number

Society Account Name * Enter account name

Cooperative Documents & Authorization

Required Uploads

Board Resolution / Authority Letter * PDF or Image (Multi-files allowed) No file selected

Please upload board resolution or authority letter

Registration Certificate / Bye-Laws * Cooperative Certificate or Bye-Laws No file selected

Please upload registration certificate

6-12 Months Bank Statement * Certified PDF statement No file selected

Please upload bank statement

President / Executive Valid ID * NIN Slip, Passport, or Driver's License No file selected

Please upload executive ID

Collateral Proof Document * Title deed, vehicle license, or pledge No file selected

Please upload collateral proof

Picture of Collateral Asset * Clear photo of property, vehicle or equipment No file selected

Please upload collateral photograph

Authorized Signature & Resolution Declaration

Authorized Executive Signature *

Sign here using finger, stylus or mouse

Your electronic signature binds this credit facility application.

Please provide your signature before submitting

I, being the duly authorized executive of this Cooperative Society, hereby declare that all information, financial disclosures and documents provided in this application are true, accurate and complete. I confirm that the Executive Committee has formally resolved to obtain this facility from Citihoms Finance Company Limited. You must accept the terms before submitting

Cooperative Finance Portal

Cooperative Society / Entity Registration

President / Primary Executive Information

Next of Kin (NOK) Information

Cooperative Facility Request

Disbursal & Settlement Account Details

Cooperative Documents & Authorization

Authorized Signature & Resolution Declaration

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