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evcf Credit operative

Society d td
NewFortis
(Because We Are (Better

DEVELOPMENT LOAN APPLICATION FORM

PLEASE ATTACH YOUR TWO ORIGINAL LATEST PAYSLIP AND ID PHOTOCOPY
Loan ID ___________
A. PERSONAL INFORMATION
1. Full Names________________________________________ 10. KRA Pin__________________________________________
2. ID Number________________________________________ 11. Contact Person____________________________________
3. Date of Birth ________________________________
________ 12. Contact Person Mobile No___________________________
4. Mobile Number____________________________________ 13. Contact Person Address _____________________________
5. Payroll Number ____________________________________ 14. Contact Person Occupation__________________________
6. Gender__________________________________________ 15. Terms of service: Permanent/Temporary/Contract/Pension
7. Work station _____________________________________
16. Position in Sacco (Committee/Member/Officer/Staff)
8. Occupation_______________________________________ Other Specify_________________________________
9. Work Station Postal Address_________________________ 17. Email address_____________________________________
B . LOAN APPLICATION AND REPAYMENT
I______________________________________ hereby apply for a loan of Kshs._________________________________
__ __ __ _

(Amt. In words______________________________________________________________________________ _ __ __ __ __ __ __ __

for a period of__________months to be paid in installments of Kshs.________________each month.

C. PURPOSE FOR WHICH LOAN IS APPLIED
1.Agriculture Code.__________________ 6. Land & Housing Code.__________________
2.Trade Code.__________________ _
7. Finance, Investment Code.__________________
3.Education Code.___________________ & Insurance
4.Human Health Code.___________________ 8.Consumption & Code.__________________
5.Manufacturing & Code.___________________ Social Services
Service Industry
D . 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 variations by the Credit Committee in respect of section B above. I hereby authorize the necessary
deductions.Including 0.54 interests per month to be made from my salary as repayment for this loan. I declare that I am not
indebted to any other Credit society, Bank or Loan Agency (except as listed herein) either as borrower or endorser.(I also declare that
in case the employer delays the deductions, i will be paying personally to the Sacco’s bank account every month to avoid accrued
interest until action is taken by the employer and Authorize the Sacco to enlist my account with credit Reference Bureau(CRB)
incase of default).
APPLICANT’S SIGN________________________DATE____________WITNESSSIGN_________________________
WITNESS NAME____________________________________________ TSC__________________________________
ADDRESS_____ __ __ __ __ __
M/NO_________________________________
__ __ _ __ __ __ __ __ __ _

E. REPAYMENT GUARANTEE
We, 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 by attachment of our
property or salary, and that we shall not be eligible for loans unless the amount in default has been cleared in full.

PN/TSC NO FULL NAMES ID NO PHONE NO SS/WORKSTATION SIGN

1
2
3

4
5
6

Shares x 3 ______________minus Guarantees_____________minus loans applied_____________Kshs. Result must be more than 0

F. COMMENTS BY THE EMPLOYER
The applicant is employed by………………………………………in ………………County and I commit to make all
the necessary deductions and remit to the Sacco as per the cooperative society Act.
Signature……………………………………………….
Name………………………………………………….............................Contacts.............................
Designation………………………………Date……………………….. Stamp……………………

G. OFFICIAL USE ONLY LOAN APPRAISAL

Date of birth………………….. Age in years…………………………….
Total Deposits Kshs………………………….. Outstanding Loan Kshs………………...
Basic Salary……………………………….. Total Deductions Kshs…………………
Net Salary Kshs…………………………… 0.66.of Basic Salary……………………
Recovery rate of Outstanding Loan……….. a) Principal Kshs………………………
(b) Interest Kshs…………………………… Loan entitled Kshs……………………..
Loan applied……………………………….. Installment required (No)………………
Prepared by………………………………….
(LOANS CLERK)
Date…………………………………………
LOANS OFFICERS COMMENT
This loan application should be accepted for the amount of Kshs……………………....repayable
in…………..installment at the rate of Kshs……………………..per month.
If rejected or amount is reduced the reasons are:-
1…………………………………………………………………………………..
2…………………………………………………………………………………

INTERNAL AUDITOR……………………………Date…………………………...

ACCOUNTANT……………………………………Date……………………………

CHIEF EXECUTIVE OFFICER

OFFICIAL USE ONLY

CREDIT COMMITTEE ONLY

Loan approved is Kshs………………………….recoverable in………months at the rate of

Kshs…………………….and 1% interest per month on reducing balance method.
REASONS FOR DEFERED LOANS
1. Incomplete information of lack of supporting documents
2. Timeliness
3. Renegotiate loan terms purpose.
4. Inadequate fund to meet the loan demand

REASONS FOR REJECTED LOAN

1. Inability to repay or bad repayment history 5. Lack of guarantors or security
2. Loan not proportional to shares 6. Membership period
3. A clear outstanding loan 7. Ineligible purpose
4. Excessive loan frequency

Credit committee as per minutes No…………………….

Chairman’s Signature…………………………………….
Member’s Signature………………………………………
Member’s Signature………………………………………