Letterhead

MOBILE PHONE BANKING APPLICATION FORM

PLEASE COMPLETE DETAILS IN CAPITAL LETTERS

MOBILE PHONE NO.

FOSA ACCOUNT NO.

Mobile banking PIN will be sent to your cell phone in form of SMS

Services available

Declaration by applicant

I hereby apply for mobile phone banking facility from SULUHU SACCO Limited. I warrant you that the information given above is true and complete and i authorise you to make any enquiries necessary in connection with this application. I accept and agree to be bound by the conditions of use. I agree that i am liable for all the charges incurred through the use of this facility. I hereby indemnify the Sacco against all losses that they may incur as a result of my use of the facility. I understand that the sacco reserves the right to decline the application without giving reasons.

For official use only

Sacco