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At La Riba Finance, we are committed to providing Shariah-compliant financial solutions that empower individuals, businesses, and communities to grow without compromising their values.

Finance required ( Amount )*

Name*

Last name*

Contact Number*

Your email*

Birth Date *

South African Identity Number*

Street Number*

Street Name*

Complex Name or Building/Office Name

City*

Country*

Postal Code*

Married Status*

Single

Married

Divorced

Married in*

In Community of Property (COP)

Out of Community of Property (ANC) with Accrual

Out of Community of Property (ANC) without Accrual

Customary Marriage

Civil Union

Not Married

Other (please specify)

Employer Business Name*

Occupation*

Employer Full Name*

Employer Contact Number*

Employer Email*

Years employed*

Gross Monthly Salary ( Before deductions)*

Other Income

Purpose of loan *

Reference 1 Full Name*

Contact Number*

Email*

Full Residential Address*

Reference 2 Full Name*

Contact Number*

Email address*

Full Residential Address*

Surety Holder Full Name*

Relationship to applicant*

Surety Holder Identity Number*

Contact Number*

Email *

Full Residential Address*

I acknowledge that the information I have provided in this loan application is true and correct. I understand that any misrepresentation of facts may jeopardize my loan approval.*

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