YES SAVINGS AND CREDIT CO-OPERATIVE SOCIETY LTD
“FOSA LOAN”APPLICATION & AGREEMENT FORM NO……………
MEMBERSHIP NO. …………………
I, Mr/Mrs/Miss……………………………………………………………..………………………. do hereby apply for a loan of Kshs……………………………..……….. in words…………………………………………………………...……………………… only to be repaid in ………………………………………………….…………………… monthly instalments of Kshs. …………………………(Maximum of 5 Monthly Instalment/s).
Date when the loan is required:……………………………………………..
PERSONAL INFORMATION
I am employed by ……………………………………………………………………………… on Permanent/Seasonal/Contract terms and stationed at ………..………………………………………….………………………...……… P. O. Box ……………………………………… I/D No……………………………………………………...
Telephone…………………………………
Position in employment …………………... ……………………………………………………………………………………………………………………………………….….
Payroll No. ……………………………………………………………………………………………………………………………………………………………………………………….
Position in Society (Member/Committee Member/Employee) ……………………………………………………………………………………..
Monthly Share contribution Kshs. …………………………………………………………………………………………….
DECLARATION
I hereby declare that the foregoing particulars are true to the best of my knowledge and belief and agree to abide by the By-laws of the Society, the Loan Policy and any variations by the Credit Committee, in respect of the “Fosa Loan” repayment terms above.
1. I hereby commit myself to repay the loan plus interest by POSTDATED CHEQUES.
2. Authorise the necessary deductions including 6% plus 0.5 % insurance interest on the amount borrowed within the stipulated time.
Signature of applicant……………………………………………………………………………………… Date…………………………………………………...... ……………….
FOR LOAN AMOUNT OF KSH 50,000 AND BELOW, PLEASE INDICATE THE MOBILE NUMBER WHERE THE FUNDS WILL BE SENT TO IF YOU WISH TO BE PAID THROUGH ZAP.
0 / 7 / 3 / Signature------/ Date------Witnessed by:
Name of Witness…………………………………………..…………………………ID/No……………….…………………….…………...……Payroll No……………………………
Employed by………………………………………………………………………………………………………….…………….…Station……………………………………………..……………..
Address……………………………………………………………………………………………………………………………………..Tel. No. ………………………………………...…………….. Signature……………………………………………………………………………………………..…………………………………….Date:……………………………………………….……………...
REPAYMENT GUARANTEE
We the undersigned, hereby accept jointly and severally, liability for the repayment of the Loan in the event of the borrower’s default. We understand that the amount in default may be recovered by an offset against our shares in the Society or and that we shall not be eligible for loans against the amounts offered as guarantee unless the amount in default has been cleared in full.
Name of Borrower:………………………………………………………………………………………………………………………………………………………..P.No:………………………………………………………………………………………………………
P/No. / Names / M/No. / Shares offered / Guarantor’sID/No. / Sign of guarantor / Name & Sign. of Witness P/No.
FOR OFFICIAL USE ONLY
RECOMMENDATIONS
Applied amount:……………………………………………………………………………
Repayment computation……………………………………………………………………
…………………………………………………………………………………………………
Repayment mode (cheque no. amount date)………………………………………………………………
Name:…………………………………………………………Signature:……………………………
CREDIT COMMITTEE CONSIDERATION
Loan approved Kshs. ……………………………….…………………. recoverable in ………………………….……… monthly instalments of Kshs…………………………………………….…….…. at a flat rate of interest of 6% plus 0.5% in every three months.
OR
This loan application has been deferred/rejected for reasons being that:
………………………………………………………………………………………………………………………………………………………………………………………………………………..……………
……………………………………..……………………………………………………………………………………………………………………………………..…………………………………………………
Credit Committee Minute No. ………………………………………………………..……………… Date…………………………………………………………………………...
Chairman Name & Signature……………………………………………………………………………………………………………………………………………………………………...
Member Name & Signature ………………………………………………………………………………………………………………………………...……………………………………..
Member Name & Signature ………………………………………………………………………………………………………………………………….……………………………………..
To be filled in duplicate
FOR OFFICIAL USE ONLY
DEDUCTIONS ADVISE TO WAGES AND BENEFITS SECTION
NAME OF APPLICANT……………………………………………………………………………………………………………………..………………………………………………….……. P/No. ……………………………….……..……
Loan No. ……………………………………………………….
Deduct Kshs……………………………………………………………………………………….………………………… for…………………………….…….…. Months with effect from ………………………………………
This translates to loan approved of Kshs. ……………………………………...…………………….. plus a calculated interest at 6% for three month on loan.
Monthly Share Contribution Kshs:……………….………………………….………..
Loan Recovery Kshs………..……………………………………………………………………
Interest Kshs:…………………………………………..………………………………………..……..
Insurance:………………………………………………………………………………………………
Loan 1 Deductions:……………………………………………………………….……………....
Loan 2 Deductions…………………………………………………………………………………………………
Loan 3 Deductions:………………………………………………….……………………………………………
Household loan:………………………………………………………………………………………………………..
Total Deduction:……………………………………………………………………………………..
Name:……………..…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….
Signature:……………………………………………………………………………………………………………………………………………….………………. Date………………………………………………………………………………………………………………………….
TO BE COMPLETED BY THE HUMAN RESOURCES MANAGER
I certify that the loan can:
Be servicedNot be serviced
according to HR regulations.
(In case not serviced is checked)
I authorise a maximum deduction of Kshs ………………………………………………………………………………………………………………………………………………………
Name: …………….………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….
Signature: …………………………………………………………………………………………………………………………………….………………………. Date…………………………………………………………………………………………………………………………….
(Stamped)
CHEQUE DISPATCH
Cheque No. ………………………………………………………………………………..……………. of Kshs………………………………………………………..………… dated ………………………………………………………………………………………….. is dispatched to/collected by…………………………………………………………………………………………………………………………I/DNo.……………………………………………………………………………………….
On………………………………………………………………………………………… (date).Signature:……………….…………………………………………………………………………………………………………..
Post Re. No………………………………………………………………………………………………………………………………………..
1