Download central kenya adventist co-operative savings

ADVENTIST CO-OPERATIVE SACCO SOCIETY LIMITED
P.O.BOX 41352- 00100 NAIROBI TEL: (020)7122711, 3580646/7
LOAN APPLICATION AND ACCEPTANCE FORM
A. APPLICANTS DETAILS:
Full Name__________________________________________________________________________________
Membership No._______________ Age: _______________________ID No._____________________________
Employer ____________________________________________ Occupation ____________________________
Mobile Phone Number ____________________________ E-Mail Address _______________________________
Bank A/c No___________________________ Bank __________________ Branch _______________________
B. LOAN APPLICATION:
I hereby apply for the following loan (Tick as appropriate)
DEVELOPMENT LOAN
SCHOOL FEES LOAN
EMERGENCY LOAN
INVESTMENTS LOAN_____________________________
INSTANT LOAN
REFINANCING LOAN
OTHER LOAN ___________________________________
Of Kshs. (Amount in figures) _____________________(Amount in words) _______________________________
__________________________________________________________________________________________
For duration of _______ months and at the approved %s of the SACCO interest rate.
Purpose of the loan being: ____________________________________________________________________
C. BORROWERS DECLARATION
I hereby declare that the foregoing particulars are true. I have not entered into a separate agreement with any
other entity not disclosed, including the bank, for a personal loan based on my salary. There has not been any
fact, event or circumstance that, alone or when taken with other events or conditions has a material adverse effect
on my employment.
Authority to employer to recover loan through check-off system and acknowledgement of the applicable terms in
consideration of the society agreeing to grant me the loan applied for, or such lower sum and at such interest,
costs and terms as it will deem fit, I:
Hereby request and irrevocably authorize my above stated employer to deduct monthly from my salary the
principle, interest, deposit, insurance and costs as shall be advised by the society and remit the same to the
Society for such period as the society shall advice from time to time; and
For as long as any such loan shall be outstanding, I hereby assign my final and terminal dues excluding pension
of whatsoever nature with my above stated employer to the Society as additional security for the payment of the
loan, and any balance upon such payment, to be credited to my account with the society., and I accordingly
hereby request and authorize my said employer to pay out the said dues to the society upon whenever they
become due and payable unless advised by the society.
I agree that in making this application, I will be bound by the society’s bylaws, loaning policy, terms and conditions
applicable to the loan taken above and that the society may grant me a lesser loan than that applied for and that
my obligations herein and under such terms shall be effective immediately upon the society crediting my account
with such loan sum by way of cheque or direct transfer as applicable. I agree that I will personally remain liable to
pay any installments of the loan and the entire loan notwithstanding any delay or failure by my employer to deduct
and/or remit the payments to the society or any insufficiency thereof.
Full Names__________________________________________________________
I authorize the payment of the loan applied above and if approved to be made thro:
o Direct Bank Transfer to the bank account given above
o Vide Society Cheque Payable to _________________________________________________________
Signed by the Applicant________________________ this ________ day of _______________ 20_ _
Witness Name ________________________________ Signature _________________Date: ________________
(NB: Only a Co-operative member should witness this form not any other person.)
D. REQUIREMENTS
(1) National Identity Card photocopy,
(2) Most current pay slip
E. REPAYMENT GUARANTEE
I / We, the undersigned, acting severally hereby guarantee the repayment of the loan by the borrower to the
extent of our liability indicated against our names. I / We hereby assign all the monetary equivalent of all our
deposits in the society as collateral security for our respective liability under this guarantee and hereby authorize
the society to recover the monetary equivalent of the said deposits, provided that the said assignment is without
prejudice to the society’s right to recover the loan from us or the borrower through any legal means.
GUARANTORS:
Co-op No. Name
Institution
Amount
Guaranteed
Signature
Date
The total amount guaranteed by all guarantors must be equivalent to cover the loan applied. Incase of selfguarantee, the Society must certify that the applicant has not endorsed any other guarantee and shall not do so
until cleared by the society.
Lack of enough guarantees will result to reduction of the loan to the extent of the guaranteed amount as per the
discretion of the credit committee. An extra form may be used for additional guarantees as needed.
F. COMMENTS BY THE EMPLOYER (TREASURER / B. MANAGER / PRINCIPAL OR AUTHORISED)
I confirm that the applicant stated in the foregoing details is employed by our organization / Institution. I further
certify that the information submitted above is correct as per our records and that the employee does not have a
current or pending disciplinary action with the employer. Subject to the rules and loans policy of the Society, I
support the application and will effect deductions as per society’s advice and will not change, alter or stop
deductions so advised unless on the society’s approval. I will further remit the same deductions as required by law
and will duly inform the society should the employee be transferred or discharged from our employment and will
duly assign and pay the society the terminal benefits provided above as additional security as per declaration.
BORROWER’S TERMS OF SERVICE: Permanent/Temporary/Contract/Retiree______________________
TERMINATION DATE (if contract or casual) __________________________________________________
Employer’s Signature____________________________________
Name_________________________________________________
Designation ____________________________________________
Date_____________________________________________
(Organization’s Official
Rubber Stamp)