Loan request · CarrotPay

Let's get your premium financed.

CarrotPay Limited is a premium finance provider focused exclusively on insurance premium financing for Individuals, SMEs, and Corporates. This form helps us understand your request and determine how we can support you with flexible financing.

It takes less than 5 minutes to complete. All information provided is treated as confidential and used strictly to assess your request. Once submitted, a member of the CarrotPay team will review your application and contact you on next steps.

Loan request
AccessBridge Capital CarrotPay
Application · No. CPL-000000

CarrotPay loan request form

  1. 1Applicant
  2. 2Financing
  3. 3Employment
  4. 4Bank
  5. 5KYC
  6. 6Consent

Applicant's Details

Please provide your basic personal or business information as it appears on your official documents. This helps us verify your identity and process your request quickly.

Not referred by a broker? Input CARROT-0000

Please fill in all required fields to continue.

Financing Information

Tell us about the insurance premium you want financed. This helps us calculate your financing amount, repayment plan, and monthly instalments.

Please fill in all required fields to continue.

Employment / Business Information

Tell us about your funding source. This helps us determine your purchasing power and repayment ability.

Please fill in all required fields to continue.

Bank Details

Tell us about your bank details. This information helps us know where to expect repayment.

Please fill in all required fields to continue.

KYC Documentation

Let us get to know you more! This information helps us verify your details and confirm your identity & request.

PDF, JPG or PNG · max 10 MB
Upload a clear photo or scan of your NIN slip / card · max 10 MB

Please attach all required documents to continue.

Terms & Declaration

Please review CarrotPay's Terms and Conditions carefully. By proceeding, you confirm that you understand and agree to these terms as part of the CarrotPay broker partnership.

I confirm that the information provided in this application is true and accurate to the best of my knowledge. I understand that CarrotPay will review this information to assess my financing request and that approval is subject to eligibility and verification.

I authorise CarrotPay to verify the information provided and to contact relevant parties where necessary for this purpose.