MSILIKALI SACCO
LOAN APPLICATION FORM
Msacco Book Number Regimental/Employment No. Branch Name Loan Number
Part 1: Personal Information
Surname: First Name
Position: Telephone No.
Department/Branch Employer Name & PERSONAL BANK ACCOUNT DETAILS
Address
Bank Name……………………………
Net income per
Account Number…………………….
Month/Year (Attach
Pay Slip)
Permanent Address (Village, T.A, District) Current Address
Part 2: Financial Information
1. Current Ledger Balances
Shares Savings Fixed Deposits Loans
2. Security offered:
Security Description Serial No. Security Value
a) All my Share contributions and deposits K
Paid and to be paid in future to MSACCO
b) Other assets(specify) Security Type K
………………………………
…………………………
3. Liabilities
Liability Descriptions Liability Value
a) Current MSACCO Loans (Total all loans) K
K
b) Other Liabilities(specify)
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Part 3: Loan Information
Type of Loan Member Material Education Emergency Ndapata
Other loan type: Specify ................................................................
The Loan Information (For Education Loans to be paid directly to school; attach invoice or offer letter
showing school bank details) (For Material Loans;provide quotation or invoice and will be paid
direct to supplier or service provider)
a) Loan Amount K Repayment Period months
Applied
b) Monthly Installment K
c) Purpose of Loan (Provide full details)
………………………………………………………………………………………………………………
………………………………………………………………………………………………………………
d) Loan Officer – Attach loan schedule
Declaration
In return for our agreeing to lend out the principal sum shown in the loan information section, you agree to
this promissory Note and Promise to pay us the principle sum together with interest as set out in the
payment schedule and any additional charge owing by you to us Collectively called the (indebtedness).
When you have paid us the full amount of the indebtedness this promissory Note will come to an end. You
agree that the “Additional provision” are part of this promissory note. You acknowledge that you have read
and understand the ‘Additional provision and agree to comply with them.
Employee`s Signature Witness:
Name ……………………………………………..… Name ……………………………………….
Employment. No…………………………………… Reg. No……………………………………..
Signature ……………………………………… …. Signature ….……………………………..
Date ………………………….……………………. Date………………………………………….
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Part 4: Key Fact Statement (KFS) Part 5: Additional Conditions and Provisions
Loan Amount 1. Events of Defaults-
Loans range to a maximum of MK20 Million • We will consider this promissory Note to be in
secured by shares/savings and additional default if you do not make a payment as required
security depending on loan product or you fail to observe any item or condition
Interest rates contained in this promissory note, or in any security
A minimum of 2.75% per month and maximum of document collateral to this promissory note.
5% per month depending on loan product. 2. Remedies –
Repayment Period • If you default under this promissory note, we may
The maximum repayment period is 36 Months require you to immediate pay all the indebtedness
subject to the loan type and all cost incurred by us in enforcing our right to
Insurance details payment of the indebtedness, including legal costs
▪ Credit Life Insurance coverage for on solicitor and client basis.
death/incapacitation • Further MSACCO reserves the right to utilize your
▪ Coverage; 100% of current loan balance as at savings or shares to settle your unpaid debts.
date of incident 3. Pledging security.
▪ Insurance company; CIC Insurance • You agree to providing additional collateral if
Fees & Charges needed, signing any necessary security
▪ Loan Processing fees: 3%, subject to a documents, and abiding by the terms within those
maximum limit of MK450,000.00 documents.
▪ Loan Insurance: 2% subject to a maximum 4. Joint and Several Obligations
limit of MK300,000.00 • If more than one person signs this promissory Note,
▪ PSM fees (Apply to PSM Deductions Only) : all promises and agreements are the joints and
0.7% of loan several promises agreement of each of you and will
▪ CRB Report fees for Loans above MK1 be binding on the heirs and representative of each
Million : MK1,500.00 of you
▪ Bank transfer fees: MK3,000.00 for all loans 5. Credit Referencing
transferred through banks • You agree to send your personal information to
▪ Loan Top up Fees: Minimum of K20,000.00 Credit Reference Bureau for Credit referencing as
and maximum to K150,000.00 depending on per regulatory requirement
loan size 6. Insurance
▪ Early repayment: One month interest • In the event of death or incapacitation, the loan
Other charges to be Paid by Customer outstanding balance shall be full paid by the
▪ Legal costs in case of need for perfection of insurance company MSACCO has partnered with
security 7. Cooling off Period
▪ Fees relating to termination or enforcement of
• You may terminate the loan contract within ten
facility e.g. Debt collectors and Valuation fees
days of signing, provided you have not accessed
▪ Fees relating to realization of security
the funds, by submitting a written notice.
MSACCO shall not level any penalties or accrue
interest during this period for cancellation of the
contract except for already incurred third party
I acknowledge that I have read and understood
charges
the summary loan terms and conditions and
agree to comply with them.
Member Name ………………………………….
Signature…………………………………………
Date……………………………………………….
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Part 5: For Official Use (Please do not write beyond this line)
No ITEM Loan Application Loan Appraisal Loan Approval
1 Member ID / KYC Completed
2 Verified Pay slip
3 Adequate Member shares &
savings
4 Savings used as collateral blocked
5 CRB report
6 Adequate collateral or security
7 Application form duly signed &
approved
8 Verified Status of existing Loans
(Performing / Non-Performing
9 Loan Collection date set to default
- 27th of each
month
10 Loan Repayment schedule
generated
11 Loan offer / contract generated &
Signed
12 Guarantor Evidence
Name
Designation
Signature
Date
Loan Recommended by: Amount Recommended
………………………… ……………… ….……….…… K
Name Position Signature
………………….
Date
Reason for amount recommended if different/provide status of any outstanding loan
Loan Checked and Verified by:
……………………………………………………………………………………………………………………
Name Position Signature Date
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Part 6: For Credit Committee Use – Please do not write below this line
Credit Committee
Loan Amount applied Loan Amount Recommended Loan Amount Approved
Reason for Denial or partial Approval
Official Stamp
Approval Authority:
Name………………………….….. Name………,,,,,,,,,…………….. Name………………………………
Designation ……………………... Designation.…………………….. Designation………………………
Signature .……………………... Signature……………………….. Signature………………………….
Date……………………………… Date ……………………………... Date……………………………….
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