Loan Form First Name *Last NamePhone *Email *Street Address *Apartment, suite, etcCityState/ProvinceZIP / Postal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweUsername *Password *Confirm Password *How did you know about us? through : *SelectJabulani(JB)Google searchOtherRole *Please select roleIntern/TraineeEmployee(permanent)Contractor/BusinessSelf employed*Please select your current economic roleLoan amount-Trainees and intern limit *Please select amountR 1000R 1500R 2000R 2500R 3000N/A-I am on the business owner limit*Please select the loan amount neededLoan amount-Business owners limit *Loan amounts for business ownersN/A-am on the employee limitR 4000R 6000R 8000R10 000R15000R20 000R25 000R30 000R35 000R40 000R45 000R50 000Please select the loan amount you needInterest charge *35% Interest charge*By checking this box you confirm and agree to our monthly interest rate chargeSelect your collateral *Please select the collateral or item that will be used as security against your loaned amountN/AApple-smart phoneApple-Laptop/ComputerVehicleOtherBusiness owners only( please select N/A when if you are a trainee or intern)Collateral descriptionPlease describe your collateral, e.g brand name, model and model year. Enter N/A when this is not applicableUpload ID picture *Choose FileNo file chosenDelete uploaded fileUpload selfie picture *Choose FileNo file chosenDelete uploaded fileThis is to match the applicant to the ID picture for validityBank statements *Drag and Drop (or) Choose Files*Please upload your past three months bank statementsSupporting documents *Drag and Drop (or) Choose FilesPlease upload the following where applicable : 1) Employment contract or payslip 2) CIPC business docs 3) Proof ownership of a collateral 4) Pictures of a collateral showing atleast 4 angles, front, back, and sides.Upload Proof of Address *Choose FileNo file chosenDelete uploaded file*This can be your lease agreement or lease invoiceConsent **Please note that by clicking this button, you consent to Yellow River Loans(YRL) :-using the PDFs uploaded to assess your affordability of the loan -charging interest on the loan you(as client) applying for and -that you( as client) will pay back both the capital and interest amounts month endBank account *Choose FileNo file chosenDelete uploaded file*Please upload proof of bank account information where the funds will be sentApply