NGARISHA SACCO SOCIETY LIMITED
1199 - 50200 Bungoma
Email Address:
[email protected] Mobile No: +254 LandLine: +5020030286
Report Date: 8/3/2024 12:07:51 PM
Loan Form
PART 1.PARTICULARS OF APPLICANT: Attach copy of ID(Please fill in or tick as appropriate
Account Number Name Phone Number Gender Marital Status
001-015401-001- HILLARYWERE BARASA +254729178948 Married
001
Physical Address Postal Address County Division Zone School
............................................................................................................................................................................................................................
PART 2. EMPLOYMENT DETAILS:
Name Of Employer: ................................................Personal/Staff No./Employment No. .......................................
Station ......................................... Designation ................................... Department .....................................
Terms Of Employment:Permanent................Contract..........................If On Contract,State Expiry Date.........................
Loan Purpose................................................................. ..................................................................
PART 3. GUARANTORS DETAILS
S.No Full Name PF/TSC NO ID NO Phone No Shares Sign
Guaranteed
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
PART 4 LOAN DETAILS
Loan Type County Development Loan Loan Amount 300,000.00
PART 5:AUTHORITY TO RECOVER LOAN
I/We,...........................................................................................Whose Particulars Are As Indicated Above,Do Hereby Give Ngarisha
Sacco Irrevocable Authority To Recover From My/Our Salary/Savings Kshs 6,582.61 P.M Over a Period Of. 84 Months Without
Failure
.
ID Number.................................................................. Signature.............................................................................................
PART 6 TERMS & CONDITIONS
Mode Of Payment
The Sacco Expects The Following MODE OF REPAYMENTS to be effected:
CHECKOFF, SALARY OR CASH DEPOSIT
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Save Regulary,Borrow Wisely And Repay Promptly
NGARISHA SACCO SOCIETY LIMITED
1199 - 50200 Bungoma
Email Address:
[email protected] Mobile No: +254 LandLine: +5020030286
Report Date: 8/3/2024 12:07:51 PM
Loan Form
Interest
Interest Will Be Charged At The revailing Market Rate And be Applied At The End Of
Each Month.
NOTE:.Failure to recover from the guarantors the soociety shall attach personal effects to
offset the defaulted Loan.
Applicants Name..........................................................................ID Number........................... Signature ....................
In The Presence Of:Name.................................................................Signature ................................................................
ID Number......................................Date...........................................Address...................................................................
ITEMS REQUIRED
1.Original & Copy Of National ID Card
2.Original 3 Most Recent Consecutive Months Pay Slips
3.Guarantors Should Earn Through Fosa Or ShareHolders
4.Account Statement For Last 3 Months,If Salary Account Not In Fosa(Private Institutions)
5.Photocopies Of Guarantors National ID Cards
CONSENT TO CREDIT BUREAU REFERENCE LISTING
I .......................................................................... IDNO.......................................................................... Confirm That I Have
Authorized Ng’arisha Sacco To Share My Credit Information, And To Access My Credit Profile From Credit Reference Bureau.
Signature.......................................................................... Date..........................................................................
SACCO OFFICIAL
Registered/Appraised By..............................Amount Ksh...........................Date................Sign...................................
Approved By..........................................Amount Ksh............................Date..........................Sign...................................
Disbursed By.............................................Amount Ksh............................Date.......................Sign....................................
Authorised By..............................................
AUTHENTICATION BY CREDIT COMMITTEE
APPROVED COMMITTEE MIN NO............................................................................................................
1.COMMITTEE CHAIRMAN SIGNATURE...................................................................................................
2.FIRST...................................................................................................................................................................
3.SECOND MEMBER............................................................................................................................................
INTERNAL AUDIT OFFICE
...........................................................................................................................................................................................
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