Welcome To Seylan Merchant Bank


Application for your SMB Quick Cash Facility


Title
*First Name
*Last Name (surname):
*NIC No :
Home Telephone :
Office Telephone :
Fax :
*E-Mail Address:
*Residential Address:
Name and address of employer:
Designation :
*Present salary (LKR):
Date of employment:	dd/mm/yyyy
Nature of Business:
*Amount required (LKR):
*Repayment period :
Source of repayment:
Branch Preferred by You:
Comments :
*This information is needed to help us to personalise our reply according to your needs.