PART 4: FOR OFFICIAL USE ONLY FORM No.
MNS-3a
LOAN VETTING
4.1 The guarantors have been vetted and confirmed that their details including names, TSC and ID numbers Mwalimu Towers, Hill Lane, Off Mara Road, Upper Hill
and signatures are conforming to the details held in our records / files except starred *(if applicable) whose
P.O. Box 62641-00200, City Square, Nairobi, Kenya.
Tel: 020-295 60000, 0709 898000
details are not correct or have guaranteed more than eight loans. SMS No. 20156
Email: mwalimu@mwalimunational.coop Website: www.mwalimunational.coop
4.2 Comments by the vetting officer
Names (in full) Signature Date MWA/001/LA/...................................
LOAN APPLICATION FORM
4.3 Confirmed by: Official
Stamp:
Names (in full) Signature Date
*For Official Use Only*
RECEIVED BY: NAME SIGN DATE
LOAN APPRAISAL
4.4 Loan ability has been computed in consideration of shares ability, salary ability and the amount guaranteed PART 1: INSTRUCTIONS
4.5 Amount of loan recommended Kshs. In words “Applicant must read the following requirements and instructions before completeing this form”
Repayable in Months 1.1 Application must be made on official loan form fully completed 1.11 Vision loan will attract a processing fee of 1% of the amount
and appropriately signed by both the lonee and guarantors in approved and recovered up-front
4.6 Comments by appraiser their own handwriting.
1.12 The amount applied for shall be fully covered by the loanees
1.2 The applicant is required to attach the latest original payslip plus guarantors shares
Names (in full) Signature Date (not more than one month old to the date of application)
1.3 Loans are granted in accordance with the loan policy 1.13 Minimum monthly deposits contribution for those with loans
and lending conditions existing at the time of shall be determined by the share banding on the amount
LOAN EXAMINATION application. approved
1.4 For a member to qualify for a loan consideration, he/she
4.7 I have examined and satisfied myself that this loan has been granted in accordance with the Society’s A dormant member shall not be considered for any loan.
must have contributed shares for a minimum period of 1.14
by-laws and Rules as per existing loans policy currently in force. three months, subject to the policy in force.
1.15 Minimum monthly deposits contribution for members without
Names (in full) Signature Date 1.5 Any amount of money deposited by a member either in cash or loans will be Kshs. 1000.00 per month subject to change
by cheque to boost shares shall wait for six from time to time.
months before that amount can be used to secure a
loan. 1.16 No member will be allowed to suffer deductions including loan
LOAN APPROVAL 1.6 A member whose share contributions have fallen off repayment in excess of two thirds of the basic salary.
4.8 I hereby confirm that the proper loan processing has been done in accordance with the Society by-laws, Rules the payroll but has continued repaying his/her loan and
is in need of a new loan will be required to update his/her 1.17 Members can take a second loan other than
and the existing loaning policy. shares account by repaying in cash or authorize an emergency/School Fees in addition to existing loan without
offset from loan of an equivalent amount of the
arrears. necessarily clearing the outstanding loan subject to ability
4.9 Release Code No. 1.7 Any member who clears his/her loans by cash/cheque
must wait for 1 months before qualifying for a loan 1.18 Loans shall only be paid to member’s FOSA account
Signature: consideration subject to the policy in force.
A member, whose loan is cleared through Front Office Service 1.19 If a member decides to cancel his/her loan after the process
Loans Officer Loans Manager has been finalized a fee of Kshs. 2,000/= shall be charged.
Activity (FOSA) will qualify for a loan consideration immediate-
Date Date ly under clearance conditions.
1.20 Any alteration on the loan form may cause disqualification.
For members whose loans shall be bridged through FOSA,
the loan being processed shall be credited in the FOSA 1.21 You hereby on execution of this form as an applicant explicitly
account.
LOAN DISBURSEMENT 1.8 Guarantors who must be members of the Society
and unambiguously consents to the collection, use and
transfer, in electronic or other form, your personal data as
4.10 Batch No. Date shall not guarantee more than eight major loans described in this document by and among, as applicable, the
(Normal, Development, Super and Vision) Sacco and its subsidiaries for the purpose of assessing and
1.9 The type of loan applied shall be stated with references to processing this loan application and any future product
Name (in full) Signature Clause 2.10 of page 2 analysis and marketing whether in electronic or other form.
1.10 The interest rates shall be determined by the Board of
Directors from time to time.
Member Details
Please note that:- This Loan Application Form can be downloaded from the website Revised Feb 2020
TSC/PF NO MEMBERSHIP NO MOBILE
ISO 9001:2015 CERTIFIED
Revised Feb 2020
PART 2: (APPLICANTS PARTICULARS) 2.20 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
Please affix original current payslip, copy of ID and all required supporting documents on this page society, conditions and terms of loan policy and variations by the Credit Committee. I also consent to be referenced upon this application
in the Credit Reference Bureau(CRB) and be listed in the same incase of default.
2.1 Names (in full) e-mail
I hereby authorize the necessary deductions to be made from my salary for repayment of the loan
2.2 ID No. Nationality Age
2.3 Name of FOSA Branch
Signature Date
2.31 FOSA Account No.
2.4 Current Address Code Tel No.
2.5 Institution / School County Dept
2.6 Employer Address Code PART 3: TO BE COMPLETED BY THE APPLICANT WITH LOANS TO BE CLEARED
2.7 Terms of employment: (Probation/Permanent & Pensionable/Contract/Retired (Specify)
2.8 Amount of loan applied Kshs In words 3.1 I wish to apply for FOSA clearance on my loans as indicated below:
Type of Loan Outstanding Amount
Tick the appropriate box below for the loan type and repayment period. If the desired period is not indicated specify
2.10 Type of loan and period (Specify) (I)
Normal Loan 36 Emergency Loan 24 School Fees Loan 24 Super Loan 60
(ii)
Development Loan 48 Vision Loan 84 Wezesha Loan
2.11 Purpose of the loan: (iii)
Agriculture Trade Manufacturing Finance, Investment
& Servicing Industring & Insurance (iv)
Education Human Health Land & Housing Consumption and
social activities (v) NOTE 1: Bank Loan(s) and other institutions loans to be cleared must be supported by a statement showing the current
balance to be cleared, the Bank Early Repayment Fee(ERF) and the Bank Loan Account Number.
Specify; (eg. Medical bill, Poultry farming)
NOTE 2: After receiving the bankers cheque to clear your bank loan you are expected to send back a Bank Nill Balance
statement before the difference can be paid out to your FOSA account.
(TO BE COMPLETED BY THE GUARANTORS)
(guarantors to fill their details in the table below 2.17 in their own handwriting and should sign after the 3.2 Send the Banker’s Cheque for collection through FOSA Branch
Applicant has indicated the amount applied and guaranteed both in figures and in words.)
2.12 Amount of loan guaranteed Kshs. in words Loan Account Number
Names (in full)
(Note: Amount guaranteed must be equal to or more than the amount applied for)
2.13 In consideration of granting the above loan or less amount that may be approved, we the undersigned accept Signature Date
jointly and severally liability for its repayment in the event of the borrower’s default.
2.14 We understand that if the amount of loan granted above is defaulted, it will be recovered by an offset against our
deposits in the society or by attachment of our property or salary and that we shall not be eligible for a loan
unless the amount in default has been fully cleared.
2.15 You hereby on execution of this form as an guarantor explicitly and unambiguously consents to the collection, use and transfer, in electronic or
FOR OFFICIAL USE ONLY
other form, your personal data as described in this document by and among, as applicable, the Sacco and its subsidiaries for the purpose of
assessing and processing this loan application and any future product analysis and marketing whether in electronic or other form.
LOANS SECTION
3.3 I confirm that if the member clears the outstanding loan(s) of Kshs.
2.16 We are fully aware of the loanee’s age and undertake to guarantee this loan to its full repayment.
He/She can qualify for Kshs.
2.17
No. NAME IN FULL TSC/PF NO. CELL PHONE NO. ID No. ADDRESS SIGNATURE FOR OFFICIAL USE
(SHARES) Names (in full)
1.
Signature Date
2.
3.
4. FOSA SECTION
5.
3.4 Approved (Not Approved):
6.
7. Names (in Full)
8. Signature Date
9.
10.
Confirmation of account Blockage ( For Bridged cases)
PERSONAL COMMITMENTS
2.18 Additional security other than shares and guarantors. I further pledge my future earnings as additional security for the loan so approved. Names (in full)
2.19 I authorised you to: (Please delete whichever is not applicable)
Signature Date
(a) Reduce / increase my share contribution to (in line with paragraph 1.13 of page 1)
(b) Retain my share contributions
Revised Feb 2020
