SHORT TERM LOAN APPLICATION FORM
P.O.BOX 2392-00606, WESTLANDS
TEL: +254722004065 (020) 4274065
JCC:+254722002685 (020)4272685
EMAIL: sacco@safaricom.co.ke
www.safaricomsacco.co.ke
                                                        LOAN NO……………………..
               @Safaricom Sacco
INSTRUCTIONS
Please complete in full in BLOCK Letters. Short Term Loan application Means any loan whose repayment is
12 Months and Below. All loans are paid through FOSA within an (1) Hour of Application upon completion
of dully filled form with ALL documentation attached- EXCEPT Smart Home Loan LPO ready within 48Hrs.
 Formal Employment Requirements                    Business Requirements
 Dully Filled Loan Form                            Dully Filled Loan Form
 Latest Certified payslip                          Three Months Bank Statement (Certified)
 Copy of ID                                        Copy of ID
                                                   Standing Order Instructions to the Bank
                                                   (DDA Form)
PERSONAL PARTICULARS (As per ID or Passport)
FIRST                                MIDDLE                                        SURNAME
GENDER                             ID/PASSPORT NUMBER                               DATE OF BIRTH
M        F                                                          D     D    M      M      Y      Y   Y   Y
PHYSICAL ADDRESS
EMAIL ADDRESS                                                      TELEPHONE (PREFERABLY MOBILE NUMBER)
EMPLOYER & PARTICULARS OF OCCUPATION
COMPANY NAME
                                                        1
                                                                         STAFF NUMBER
OCCUPATION
IF BUSINESS, FILL IN PHYSICAL LOCATION PRESENT WORK STATION & POSTAL ADDRESS
LOAN PARTICULARS/LOAN TYPE AS ADVISED BY LOAN OFFICER (TICK APPROPRIATELY)
NO    LOAN TYPE                                                                                    TICK IF
                                        TICK TYPE   REPAYMENT                                      APPROPRIATELY
                                        OF LOAN     PERIOD           AMOUNT           INTEREST     REFINANCING
1.    EMERGENCY                                                                       1% P.M
2.    SMART HOME LOAN                                                                 1% P.M
3.    EDUCATION LOAN                                                                  1% P.M
4.    FOSA SILVER ADVANCE                                                             5% P.M
5     HOLIDAY LOAN                                                                    1.5% P.M
6.    OTHER (Specify)
GUARANTORS – IF REQUIRED
NO.   GUARANTORS NAME               MNO /    ID/PP N0.       AMOUNT IN     AMOUNT IN WORDS       SIGNATURE   FOR
                                    STAFF                     FIGURES                                        OFFICIAL
                                    NO.                                                                      USE
1.
2.
3.
4.
5.
I agree to abide by all terms and conditions governing this product/s and any other future amendments
APPLICANTS NAME …………………………………………..….…SIGNATURE …………………………….DATE……………………….
APPROVAL CREDIT MANAGER
We herewith confirm and accept the approval above and hereby authorize the accountant to disburse the funds as
per the appropriate mode of payment for the above amount
SIGNED ………………………………………………And…………………………………………. And…………………………………….
CREDIT MANAGER                           CEO/MANAGER                           ACCOUNTANT /FINANCE MANAGER
DATE………………………………………………….DATE………………………………………….DATE…………………………………..