Harambee Sacco Society



LOAN APPLICATION FORM

(NOT FOR SALE)

|APPLICANT’S PERSONAL INFORMATION |

|Names(as appear on ID): |

|Membership No. | |Personal No. | |

|Ministry / Dept | |Current Station | |

|Mobile Number(s) | |

|E-mail address | |

|Home/ Permanent address P.O.Box: | Code: |Town: | |

|LOAN DETAILS |

|Loan Type |Emergency | |School Fees | |Development | |

|Please | | | | | | |

|Tick | | | | | | |

| |Emergency Topup | |School Fees Topup | |Development Topup | |

| |Jisaidie | |Jisaidie 2 | |Jisaidie Topup Loan | |

| |Karibu Loan | | | | | |

|Current Shares | |

|Loan amount applied for (figures): | |

|Loan amount applied for (words): | |

|Repayment period – Years: |Months: |

|Shares boost amount required: | |

JISAIDIE TOP UP LOAN DETAILS

|Loans to be bought: |*Kindly attach certified original bank statements. |

|Emergency | |Amount: |Bank Loan 1 | |Amount: |

|School Fees | |Amount: |Bank Loan 2 | |Amount: |

|Development | |Amount: |Bank Loan 3 | |Amount: |

|Total amount to be cleared | |

|PAYMENT DETAILS (Please tick one and give details). |

|FOSA | |Fosa Account Number: |

|EFT TO BANK | | |

|Name of Bank: | |

|Branch: | |

|Account Name: | |

|Account Number: | |

|DECLARATION |

I hereby declare that the foregoing particulars are true to the best of my knowledge and belief. I agree to abide by the by-laws of the society, the loan policy provisions and any other variations by the Board of the Society in totality. I will inform the Society in the event that I am transferred from my current work station / Ministry. I authorise the necessary deductions, including interest on the loan, to be made from my salary as repayment for this loan.

Signature:__________________________ ID NO:__________________ Date:________

NB) To be valid, the two pages of this this Loan form have to be printed on a single sheet of paper ( both sides).

|REPAYMENT GUARANTEE |

Guarantors are required to carefully read through this loan application form and understand the liability before signing.

We, the undersigned,hereby accept jointly and severally, the laibility for repayment of this loan in the event of the borrower’s default. We understand the amount in default may be recovered from our salaries, offset against our shares within the society or by attachment of our properties.

| |

This is to confirm that the applicant is employed by __________________________________________________

In the capacity of_______________________________________________________________________________

I hereby confirm that the attached payslips are true copies of the applicants payslips for the months of:

_______________ / 20_____; _______________ / 20_____ ; _______________ / 20_______

We recommend/do not recommend this application to Harambee SACCO for consideration.

Name:_________________________________________________ Designation:____________________________

(Payroll Officer, HR Officer or Head of Department.)

Ministry / Department__________________________________________________________________________

Signature and Official Stamp________________________________Date:_________________________________

|FOR OFFICIAL USE ONLY |

|LOAN PROCESSING |

|Loanee Shares as at (Date): |Total Shares: |

|Captured by: |Date: |Signatue: |

|Verified by: |Date: |Signature: |

|Scheduled by: |Date: |Signature: |

|Recommended by: |Date: |Signature: |

|Remarks (if any): |

|CREDIT COMMITTEE APPROVAL |

|We have totally examined the above aplication and have approved the following: |

|Loan Type: |Loan Amount: |

|Number of Installments: |Interest rate: |

|Reference Schedule number: |Meeting date: |

|Signed: | |Signed: | |Signed: | |

| |Chairman | |Member | |Member |

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FORM NUMBER:

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