Serial No: __________

LOAN APPLICATION AND AGREEMENT

A. APPLICANT’S PERSONAL INFORMATION

Applicant’s Name Loan Number

Employment Number FOSA Account Number National I/D No

Member number Date of birth Gender

Male Female
Pin No Email:
Postal address Mobile No: Landline Phone Number
Physical address: Town Estate Street House Number
Marital Status: Single Married Widowed Others

Number of dependants

B. EMPLOYMENT DEATAILS
Applicant’s Employer Postal Address
Physical Address Tel
Designation Retirement Date: Provide proof of other income beyond retirement date

Employment terms: Permanent Casual Contract Others (specify)

C. LOAN PARTICULARS
LOAN Normal Emergency College Fee Devt Loan School Fee Karibu Other(specify)
TYPE

(For Normal/ Devt Loan attach 3 latest original payslips)

Purpose of loan
Amount applied for in figures Repayment period Months
Amount applied for in words
NB: Alterations on amount applied above will not be allowed
LOAN IN OTHER BANKS/ FINANCIAL INSTITUTIONS/CHAMA
Name of the Bank/ Institution Amount advanced Date granted Repayment Outstanding balance
Period

(Attach additional paper if necessary)

D. SECURITY DETAILS
I offer the following Security

Salary Deposits and Savings Guarantors Others Specify

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CAUTION
Guarantors are advised to read all the information supplied in this form by the applicant and terms and conditions
contained herein in order to understand full implication of loan guarantee.
E. REPAYMENT GUARANTEE
We, the undersigned, hereby accept jointly and severally, liability for the repayment of this loan in the event of the
borrower’s default. We understand that the amount in default may be recovered by an offset against our deposits or
attachment of our property, salary, FOSA deposits and other property owned by us.
NB: Guarantors MUST attach copy of ID
M/Number Name Emp Number Mobile Number ID number Signature
1.

Amount Guaranteed in Figures: in words:

2.

Amount Guaranteed in Figures: in words:

3.

Amount Guaranteed in Figures: in words:

4.

Amount Guaranteed in Figures: in words:

5.

Amount Guaranteed in Figures: in words:

6.
Amount Guaranteed in Figures: in words:
7.

Amount Guaranteed in Figures: in words:

8.
Amount Guaranteed in Figures: in words:

F. CREDIT COMITTEE
Credit committee minute No__________________________________________________________________

Chairman’s Signature _____________________________ Date_______________________________

Member’s Signature_______________________________ Date_______________________________

Member’s Signature_______________________________ Date_______________________________

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 G. LOAN AGREEMENT AND DECLARATION
In consideration of Taraji SACCO Society Ltd. (“the society”) granting me the amount of loan herein applied for
or as may approved by its Board of Directors, I hereby declare THAT,
1. I am a member of the society and shall not withdraw from the society do or omit to do anything which may
result in my said membership being withdrawn, suspended or cancelled while the loan herein is outstanding.
2. My deposits together with those of my guarantors are sufficient over and secure the loan amount applied
for herein,
3. My current and future employers are authorized to deduct and directly remit, from my salary or wages, the
amount indicated herein or as may be advised by the society as the monthly repayment amount until payment in
full. These instructions shall remain irrevocable until the loan amount herein has fully been repaid together with
interest thereon as may from time to time be advised by the society.
4. In the event that I am not salaried at the time of entering this agreement or I have opted to service the loan
through other means other than by the way of check off by the employer, I undertake to give and maintain such
security as the society may consider adequate and to review it from time to time as may be advised by the society. I
shall also give to my bank an irrevocable standing order for the monthly repayment amount indicated herein
remains unpaid.
5. I understand that the society may, at its sole discretion, treat as a breach of loan conditions should a
member revoke the instructions in paragraph 3 above without obtaining the prior consent of the society.
6. In the event that my current employment is for whatever reason terminated while the loan herein is not
fully repaid, I shall immediately and not later than 14 days notify the society, and in the event that I have taken up
new employment to immediately notify the society of the details of the new employment.
7. In the event that I should, for whatever reason leave the service of the present employer, any sum of money
due from me to the said employer to settle any balance remaining unpaid on account of the loan amount herein.
8. I understand that I am obliged to repay the loan amount and the interest as stipulated in this agreement or as
may be advised by the society from time to time. In the event that I default in servicing the loan or in any manner
breach the loan conditions, the society reserves the right to recover the amount due under this agreement by
settling off against my deposits or other monies held in my account(s) with the society or any of its affiliates, or
employ any other means to recover the outstanding amounts including attaching my property.
9. I understand that in the event that i default in servicing the loan amount herein, the Society reserve the right
to share my credit information with other financial institutions, public authorities and the licensed Credit Reference
Bureaus, subject to any applicable law. I warrant that in the event of disclosure of my credit information as stated
above, I shall have no claims against the society or any of its officers, servants, directors or agents, and I shall
indemnify the Society against any loss or injury arising out of any claim brought by myself or on my behalf or a
result of such disclosure.

H. GENERAL TERMS
It is hereby mutually agreed and declared that the following terms and conditions shall in addition to the fore going
apply to this agreement.
a. The loan amount in this agreement shall be available to the borrower on completion to the satisfaction of the Society
of all formalities appertaining to the security of the loan.
b. The borrower shall pay interest on the loan amount outstanding at the prevailing rates or at such other rate as the
Society may in its sole discretion determine and shall pay such interest in arrears.
c. The society reserves the right to determine, change the rate of interest and/ or the basis on which it is calculated.
d. The loan repayment frequency shall be once a month, or as may be advised by the Society from time to time.
e. Fees and charges to cover administrative cost shall be paid by the borrower. Such fee and charges will be in
accordance with prevailing Society tariffs.

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I. DISBURSMENT

Name of witness_________________________ M/No___________ ID No___________Signature_____________

Applicants Signature______________________ Date________________________

J. FOR OFFICIAL USE

APPROVAL

Amount recommended by appraisal officer Kshs_______________ to be paid in ______________per month

Signature of the recommending Officer___________________________________ Date_________________

Amount approved by the approving Officer________________________________ Date_________________

Signature of the Approving officer _______________________________________Date_________________

Signature of the Authorizing officer ______________________________________Date__________________

INTERNAL FORM MOVEMENT

RECEIPT DISPATCH

No DATE TIME DEPT SIGN DATE TIME DEPT SIGN

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