CONFIDENTIAL
A)
1. FULL NAME MOBILE NO
2. PRESENT ADDRESS
3. PHYSICAL ADDRESS
a) Sub location
b) Location
c) Sub County
d) County
4. Email address
5. EMPLOYER
6. SCHOOL/STATION OF WORK
7. FOSA ACC NO
8. T.S.C NO / PERSONAL NUMBER
9. AGE
10. I.D NO
M/NO
11. AMOUNT APPLIED KSHS IN WORDS
12. REPAYMENT PERIOD WITH EFFECT FROM THE MONTH OF
13. REPAYMENT TERMS (Tick)
14. MODE OF PAYMENT (Tick)
15. Interest rate 13%
16. PURPOSE OF THE LOAN (Tick) (At least one required)
Attach current payslip/Statement and ID card Photostat
I hereby declare that the foregoing particulars are true to the best of my knowledge and belief and agree to abide by the laws of the society and the loan policy and any variations by the Board of Directors.
I hereby authorize Suluhu SACCO Society LTD to access my credit information from CRB and be enlisted in case of default.
I hereby confirm my decision: -- Select -- ✅ I Agree to the Application ❌ I Decline the Application DATE
B. WITNESS NAME M/NO SIGNATURE
Management committee minutes
Date
Chairman’s Signature
