TABASURI DT SAVING & CREDIT CO-OP SOCIETY LIMITED

P.O Box 80862-80100 MOMBASA, KENYA

Tel: 0414-470062, 0772-762880
Email: info@[Link] Website: [Link]

MWANANCHI LOAN APPLICATION AND AGREEMENT FORM

TAB/ 001/………………...
For official use
Received by: Sign:

Official Stamp: Date

PART 1: INSTRUCTIONS
“Applicants must read the following requirements and instructions very carefully before completing this form”

1.1 Application must be made on the official loan form fully 1.11 A dormant member shall not be considered for any loan
completed and appropriately signed by both the loanee and unless they regularizes their savings.
guarantors in their own handwriting. 1.12 Minimum savings contribution for members without
1.2 The Applicant is required to attach original payslip (not loans will be Kshs. 1,000 per month, subject to change
more than two months old to the date of application) and a from time to time, and Kshs 1200 for those with loans
copy of National ID card showing both sides. 1.13 No members will be allowed to suffer deductions includ-
1.3 Loans are granted in accordance with the loan policy and ing loan repayment in excess of two thirds of the basic
lending conditions existing at the time of application. salary.
1.4 For a member to qualify for loan consideration he/she 1.14 Loans shall only be paid to member’s savings Account.
must have contributed shares for a minimum period of 2 1.15 If a member decides to cancel his/her loan after the
months, subject to change from time to time. process has been finalized, a fee of Kshs.1,000 shall be
1.5 Any amount of money deposited by a member either in charged.
cash or by cheque to boost shares shall wait for 1 month 1.16 Any alteration on the loan without any attestation may
before that amount can be used to secure a loan otherwise cause disqualification.
it will attract charges. 1.17 Attachments;
1.6 Guarantors who must be members of the group shall not i. Applicant ID Copy
guarantee more than their non withdrawable savings in the ii. Co-borrower ID Copy
society. iii. Passport Photo
1.7 The interest rates range depends on the type of loan.
1.8 All loans will attract a processing fee of 2.5% of the amount Note:
approved recovered upfront. By signing this Loan Form, you allow us to reference
1.9 The amount applied for shall be fully covered by the and list you negatively to the Credit Reference BureauCRB),
loanee’s plus guarantors deposits. incase you fail to service your liabilities satisfactorily and in
1.10 Minimum savings contribution for those with loans shall be time
determined by the deposit depending on the amount ap-
proved.

Jawabu tunalo
 MICRO-FINANCE LOAN APPLICATION FORM
A. APPLICANTS PARTICULARS B. CO-BORROWER PARTICULARS (SPOUSE)
NAME: NAME:

ID NO: ID NO:

POSTAL ADDRESS: POSTAL ADDRESS:

EMPLOYER: EMPLOYER:

RESIDENTIAL ADDRESS: RESIDENTIAL ADDRESS:

MOBILE NO: MOBILE NO:

C.
GENDER: MALE FEMALE MEMBER NO …………………..
THE INDIVIDUAL BUSINESS (MANDATORY)

TYPE OF BUSINESS: …………………………………………………………………………………………………………………

LOCATION:……………………………………………………………………………………………………………………………
DATE STARTED:……………………………………………………………………………………………………………………..

D. LOAN REQUEST
Amount Requested (Kshs) (a) ……………………………………….. Loan Cycle (1 st, 2nd, 3rd etc.)……………………….
Amount LAF (b) …………………………………………………….. Amount of previous loan……………………………
Appraisal fee (c) …………………………………………………….. Loan Period (Months)……………………………….
Amount sent to account (d) ………………………………….………. 1/3 Rule…………………………………………. …..

E. BUSINESS PERFORMANCE ASSESMENT

CURRENT TOTAL CURRENT TOTAL SALES PER TOTAL OTHER IN- TOTAL
ASSETS (A1) LIABILITIES MONTH (C1) COMES (D1)
B1)
STOCK CREDITORS MONTH 1 RENT INCOME

DEBTORS LOANS MONTH 2 SALARY

OTHERS EXPENSES MONTH 3 OTHERS

NET CASH FLOW= C1+D1-BI

F. ITEMS PLEDGED

YEAR OF PURCHASE CURRENT

ITEMS PLEDGED MAKE SERIAL NO
PURCHASE PRICE PRICE VALUE
1
2
3
4
5
6
7
8
9
10
Total

Jawabu tunalo
G. LOAN SECURITY DECLARATION

I…………………………………………….of ID No……………….…………………..certify that I possess and own the above listed items and
wish to declare that incase of any late payment, I authorize TABASURI SACCO and my guarantors express authority to immediately possess and
auction the above mentioned items to recover the loan balance and any penalties.
Name of Applicant…………………………………………………....Tel……………………Sign…………………..Date……………………...
Name of next ofKin…………………………………………………...Tel……………………Sign…………………..Date……………………...

H. LOAN COMMITMENT
My current savings pledge as security are Kshs……………………………..which is for my loan and that of TABASURI DT SACCO members
whom I have also guaranteed.

[Link] DECLARATION
We…………………………………..…………………..Self Help Group herby certify that…………………………………………....…..of ID
No………………………………..is a member of our group and wish to confirm that the items pledged as security and are his/hers and they have
been physically seen by:-

J. GROUP GUARANTEE
DATE NAME ID NUMBER MEMBER NO SIGN AMOUNT OF
DEPOSITS

TOTAL

We therefore recommend and guarantee him/her for a loan of Kshs…………………..as requested.

Name of Chairperson…………………………………………………………..…..Sign…………………..….Date………………..….……..
Name of Secretary…………………………………………………………………Sign………………………Date…………………..……...
Name of Treasurer………………………………………………………………...Sign……………………….Date………………………….

Chief/Assistant Chief approval: …………………………………………………………………………………………………………………

[Link] PLEDGE TO TABASURI DT SACCO

I………………………………………………………………….…..….of P.O Box…………….……………..……Tel…………….……………
commit myself to repay the total of Kshs…………………(interest included) charged at an interest rate of ………% per month on equal monthly/
weekly installments of Kshs…………………..My monthly repayment date is……………………..Should my installment be late I agree to pay a
penalty of 10% of the loan amount not paid. I further commit myself to abide with all Terms and Conditions set by TABASURI DT SACCO LTD.
Applicant sign……………………………..D No………………….………………..….Date…………………………

FOR OFFICIAL USE

LOAN VETTING
4.1 The guarantors have been vetted and confirmed that their details including names, ID numbers and signatures are confirming to
the details held in our records/files except stared*(if applicable) whose details are not correct or have guaranteed more than six
loans.
4.2 Comments by vetting officer………………………………………………………………………………………………………..
Jawabu tunalo
FOR OFFICIAL USE
LOAN APPRAISAL
OUTSTANDING LOAN BALANCES
PRINCIPLE INTEREST
LOAN TYPE P.R DEDUCTION CORRECT DEDUCTION
AMOUNT AMT

4.3 Deposits…………………..x4= Kshs…………………………

4.4 Requested amount Kshs……………………………………….
4.5 1/3 Rule Requirement…………………………………………
4.6 Amount Recommended by Appraisal Officer…………………
4.7 Loan Application is Deferred/Rejected/Reduced due to ……………………………………………………………………………
4.8 Loan ability has been computed in consideration of shares ability, salary ability and the amount guaranteed.
4.9 Amount of loan recommended Kshs……………In words……………………………………………………………....Repayable
in ………….Months.
4.9.1 Comments by appraiser…………………………………………………………………………………………………………….

Name (in full)……………………………………………….Signature………………………. Date……………………………...

LOAN EXAMINATION
5.0 I have examined and satisfied myself that this loan has been granted in accordance with the society’s by laws and rules as per the
existing loans policy currently in force.

Name (in full)………………………………………......Signature…………………………..Date…………………………...

LOAN APPROVAL
5.1 I hereby confirm that proper loan processing has been granted in accordance with the society’s by-laws and rules as per the
existing loans policy currently in force.

Loan Manager…………………………………………..Sign………………………………….Date…………………………….

LOAN DISBURSEMENT

5.2 Voucher No. ………………………. Cheque No……………………….. Date………………….

Name (in full)…………………………………………... Signature…………………………………...

CREDIT MEETING
Loan approved, Kshs…………………………………………...(in words)……………………………………………………………... recoverable in
………...months, at an interest rate of ………...percent per month on a straight line method.

Credit Meeting Minute No……………………….. Date………………………………

Chairman’s Signature……………………………. …..

Member’s Signature…………………………………….

Jawabu tunalo