The Application Should be completely filled otherwise specify "N.A." (Not Available).

P.S.: The Bank keeps the right to accept or decline any application at its own convenience.

I hereby certify that the information provided to you by me is true, correct & complete. I authorize Banque de l’Industrie et du Travail s.a.l. to make whatever inquiries deemed to be necessary and appropriate for the purpose of evaluating my credit application. Furthermore, my affixed signature hereunder verifies that the conditions of the loan plan have been explained to me and accepted by me. I also undertake to inform the bank of any changes on my afore situation.