COSMOPOLITAN DEPOSIT TAKING SACCO SOCIETY LTD

P.O BOX 1931-20100 NAKURU TEL 051-2212416 /0722 388616.

www.cosmopolitansacco.com e-mail: [email protected]
NAIVASHA BRANCH 0700470339
BAHATI BRANCH 0700470342
MOLO BRANCH 0716861224
NAROK BRANCH 0717546502
GILGIL SATELITE 0796471764
UNITED WE GROW SUBUKIA SATELLITE 0790261086
MWISHO WA LAMI SATELITE 0115819417

LOAN APPLICATION & AGREEMENT FORM

A.APPLICANTS PERSONAL INFORMATION

Name …………………………………………………………TSC/P/F NO………..…………M/NO…………… ID No………………………
Pin number…………………………………………….Date of birth ……………………..Gender ………………………………………..
Email…………………………………………………Postal Address……………………………….Mobile No…………………………………
Physical Address………………………………..Estate………………………Plot No…………………………………/nearest
Land mark……………………………………………………………………………………………………………………………………………..
Rented Owned Period you have lived there _________________years
Alternative contact person Name ………………………………………….Mobile No.…………………………………………
Group Name……………………………………………………….area of operation……………………………………………………..
Registration No………………………………………………..Date of formation……………………………………………………….

B. EMPLOYMENT DETAILS
Applicant’s employer ……………………………………Address ………………………………………………………………………
Physical Address …………………………………………………………..Phone No……………………………………………………….
Designation ………………………………………………………Retirement Date ……………………………………………………….
Assets owned ……………………………………………………………………………………………………………………………………..
If self employed (attach 6 months bank statements, 1 year cash flow)where applicable.
Type of business & years of operations ……………………………………………………………………………………..
Monthly Business income (Kshs.)……………………………………………………………………………………………..
Business Location ……………………………………………………………………………………………………………………….
BUSINESS SEGMENT(TICK APPROPRIATE SEGMENT
Small Scale Business (Monthly turnover below Ksh50,000/=)
Medium Scale Business (Monthly turnover between Ksh50,000/= to Ksh100,000/=)
Large Scale Business (Monthly turnover above Ksh 100,000/=)

C.LOAN PARTICULA
I hereby apply for (tick)
Loan Type
Development Loan Okoa Jahazi Loan Refinance Loan
Emergency Loan Boresha Loan Restructured Loan
Education loan Jijenge Loan Makaribisho loan
Wezesha Loan Chama Loan Biashara Loan
Contract Loan Grant loan Pensioners loan
LOAN PURPOSE(Tick appropriate Sector)
Agriculture Trade Manufacturing/Service Industries
Education Land/Housing Financial Investment/Insurance
Human Health Consumption/Social Activities

Amount applied for Kshs ………………………(Amount in words)……………………………………………………………………..

………………………………………………………………………………………………………………Repayment period ……… Months.

N.B. ALTERATIONS TO BE COUNTER SIGNED FOR

Loan in other banks/Financial Institutions

Name of bank Amount advanced Repayment period Outstanding balance

D.SECURITY DETAILS (TICK)

Salary Deposits Guarantors Collateral

Others specify________________________________________________________________

CONDITIONS

The applicants non committed deposits plus those of the guarantors must be sufficient to secure the loan. The
society may at its discretion reject a guarantor proposed by an applicant. Only 70% of the value of the collateral
used by the applicant(s) will be used to secure the loan.
E. GUARANTORS SCHEDULE

We the undersigned hereby accept jointly and severally for the repayment of the 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 in the society or by attachment of our property or salary and that we shall not be eligible for loans
unless the amount in default has been cleared in full.

P.NO TSC NO NAME DEPOSITS ID.NO MEMBER NO SIGNATURE DATE

N.B. Guarantor’s ID to be attached.

E. LOAN AGREEMENT/DECLARATION

1. My current/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 monthly repayment until loan is fully
paid. These instructions shall remain irrevocable until the loan and interest is fully repaid.
2. If self employed I shall give to my bank an irrevocable standing order for the monthly repayment amount
indicated herein, or as advised by the society in favour of the society, and I shall not revoke the said
standing orders while the amount herein remains un paid.
3. I understand that the society may at its sole discretion, treat as a breach of loan conditions should I
revoke the instructions above without the prior written consent of the society.
4. I understand that I am obliged to repay the loan amount and interest as stipulated in this agreement or
as may be advised by society from time to time. In the event I default the loan or in any manner breach
the loan conditions, the society reserves the right to recover the amount under this agreement by
settling off against my deposits or other monies held in my account(s) with the society or employ any
other means to recover the outstanding amounts including attaching my property.
5. I understand in the event I default the loan the society reserves the right to share my credit information
with other financial institutions, public authorities and the licensed credit reference bureaus subject to
any applicable law. In the event of the disclosure of my credit information as stated above, I shall have
no claim against the society or any of its officers, directors or agents.
6. In case of a FOSA Loan, I declare I shall not change my pay point to elsewhere until my loan facility is fully
repaid.
7. Incase my employer fails to effect my loan deductions in time I will remit the deductions for the
month(s) not paid.
8. Society reserves the right to bridge/clear any loan as governed by the Sacco credit policy.

F. GENERAL TERMS

It is hereby mutually agreed/declared the following terms and conditions in addition to the foregoing
shall apply to this agreement:-

(a) The loan shall be available to the borrower on completion to the satisfaction of the society of all
formalities pertaining to the security of the loan
(b) Society reserves the right to determine, change the rate of interest and or the basis, on which it is
calculated.
(c) The loan repayment shall be on monthly basis as per the agreement
(d) Fees and charges shall be paid by the borrower in accordance with the prevailing society tariffs and as per
the valuer and lawyer’s fees in case of collateral.
(e) In the event of default the society reserves the right to involve the society debt collectors to follow up the
debts at the cost of the member.
(f) In case of restructuring of a loan, terms & conditions of loans will apply.

Applicant’s Signature ……………………………………………………….Date ……………………………………………….

G. EMPLOYER’S COMMENT(WEZESHA AND CONTRACT0
This applicant is employed by……………………………………………….of…………………..(Town) I recommend the
application. I will inform the society should employee be discharged from employment.

TERMS OF EMPLOYMENT

Permanent Renewable Contract fixed Contract others.

Specify…………………………………………………………………………………………………………………………………………

If on contract, contractual Periods Starts………./……../20…. To ………../…../20………

HEADTEACHER/PRINCIPAL/HUMAN RESOURCE………………………SIGNATURE………………OFFICIAL STAMP………………..…

G. FOR OFFICIAL USE

Application received by name ____________________Signature______________Date____________

Special ConsiderationRemark______________________________________________________________

___________________________________________Name_________________Signature_____________

Loans Manager recommended amount Kshs._________________________________________________

CRB STATUS Listed. Not Listed. CRB Comment_____________________________
Name _________________________Signature________________________Date____________________

Checked by Internal Auditor Name_________________Signature_______________Date______________

Authorized by C.E.O/Deputy C.E.O Name ___________________Signature___________Date__________

CREDIT COMMITTEE

Loan amount approved Kshs.______________recoverable in ____________months installments

Reasons for deferred/Rejected loans:-

1. _____________________________________________________________________________
2. _____________________________________________________________________________
3. ______________________________________________________________________________

Credit Committee Minute No.________________________________________________________

Chairman’s Signature _____________________________ Date ____________________________

Secretary Signature _______________________________ Date______________________________
Member Signature_________________________________Date______________________________