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I Confirm That I First Name Last Name 1. I am not a minor 2. Except as declared, I am not subject to any Court order which may affect my eligibility for this loan3. I do not have any current matters pending for debt, restructuring or alleviation4. I will notify Botswana Savings Bank (BSB) in the event that I change my banking arrangements, or employer and ensure that my stop/debit order to BSB is not interrupted.5. I agree that proceeds of this loan (if applicable) be credited to my BSB Transactional Account 6. I accept that interest will apply as per BSB credit policy.7. By signing below I authorise the bank to deduct an administration fee and any insurance premium/s where applicable.8. By signing below I declare that all the information I have provided is to the best of my knowledge honest and true. I am aware of the consequences of giving false Information and I also accept that should the information provided be found to be untrue, the Bank has the right to nullify my application. Signature Date
Customer Submission: Date Time: Time AM PM Signature: Signature CSA/DSA Received: Date Time: Time AM PM Signature: Signature BM/TLDSA Received: Date Time: Time AM PM Signature: Signature ALP Received: Date Time: Time AM PM Signature: Signature SLP Received: Date Time: Time AM PM Signature: Signature ACR Received: Date Time: Time AM PM Signature: Signature SCR/MCO/DR/CC: Date Time: Time AM PM Signature: Signature ALP Date: Date Time: Time AM PM Signature: Signature SLP Date: Date Time: Time AM PM Signature: Signature