LOAN APPLICATION FORM

CCO SOCIE
SA

IA

TY
SHER

LTD
er.
Ins
re

ow
pi
,E p
q u ip, E m

SHERIA SACCO SOCIETY LIMITED

HEAD OFFICE
Tel: 020 - 7801500
P. O. Box 34390-00100, Nairobi
Email: [email protected]
Website: www.sheriasacco.coop

SACCO FOSA OFFICE

Milimani Law Courts, 2nd Floor, Community, Nairobi
Email: [email protected]

KISUMU OFFICE
Kisumu Law Courts, Old Courts.

“Inspire, Equip, Empower”

1
 • To be completed by the applicant after carefully reading and understanding the basic rules and requirements.
• No alterations are allowed.
• Please Complete Your Details in Capital Letters.
• Attach current original pay slip and copy of I.D./Passport.
• Please Complete Your Details in Capital Letters.

1. PARTICULARS OF THE APPLICANT (Tick Where Appropriate)

Name (as per the I.D.) Staff/Pj/membership no I.D. no/passport no.

Mobile number Gender male/female Marital status

Postal address Postal code Town

Email address Physical residence town Estate

Street House no. Rented /Owned

How long have you lived at your current place of residence.............................................................

2. EMPLOYMENT DETAILS (Tick Where Appropriate)

Self Salaried Retired

For Salaried Persons

Name of Employer...................................................................Telephone No:..................................

Postal Address............................Postal Code......................Town.....................................................

Physical Location.............................................................................................................................

Position/Designation.......................................................................................................................

Employment Terms: Permanent Temporary Casual Other (Specify)..................

For Non-Salaried Persons/Business Applicants

* Attach 6 months bank statement.

Business Name

Nature of Business Years in Operation

Approximate Monthly Income in figures

2
 3. LOAN PARTICULARS
Kindly Tick Where Appropriate

Loan Type Repayment Period Loan Type Repayment Period

Diamond Loan 72 Months Salary In Advance 3 Months

Development Loan 60 Months Salary Advance 12 Months

Education Loan 12 Months Personal Loan 72 Months

Emergency Loan 12 Months Business Loan 48 Months

Jipange Loan 12 Months Bima Loan 10 Months

Refinancing Loan 24 Months Shamba Loan 60 Months

Amount of Loan Applied in Figures. ...................................................................................................

Amount of Loan Applied in Words .....................................................................................................
Repayment Period ........................................................................................................................

Mode of Repayment: Check off Standing Order

Security details: I offer as security for my loan; my salary, deposits and savings, Guarantors, Title
Deed, Log Book and any other funds due to me from the society.

4. LOAN PURPOSE (Tick Where Appropriate)

SECTORIAL CLASSIFICATION OF CREDIT FINANCING BY DT-SACCOS
1. AGRICULTURE 5. HUMAN HEALTH
a) Crop Farming a) Human health and related services
b) Animal Production 6. LAND AND HOUSING
c) Agricultural supporting services a) Land
d) Agribusiness b) Housing
2. TRADE 7. FINANCE INVESTMENT AND INSURANCE
a) Whole sale and retail a) Microfinance
b) Transport b) Commercial Banks
c) Hospitality c) Mortgage Finance
d) Foreign Trade d) Insurance

MANUFACTURING & e) Investment

3.
SERVICING INDUSTRY 8. CONSUMPTION & SOCIAL SERVICES
a) Cottage Industry a) Utilities - domestic expenditure
b) Servicing Industry b) Utilities - food expenditure
c) Information Communication and Technology c) Consumer Durables
4. EDUCATION d) Social and communal expenses

a) Education and related services

3
5. GUARANTORS PARTICULARS
In consideration of granting the above loan or any other lesser amount that may be approved, we the
undersigned hereby accept jointly and severally liabilities for its payment in the event of the borrower’s
default. We understand that the amount in default may transferred to us or be recovered by offset against our
deposits held in the society, at the time the loan is approved by attachment of salary or property and that we
shall not be eligible for loans until the amount in default has been cleared in full.

NO. NAME STAFF/ PHONE NO. AMOUNT I.D.

MEMBERSHIP & POSTAL GUARANTEED NUMBER SIGNATURE
/P.J./P.F. No. ADDRESS

1.

2.

3.

4.

5.

6.

7.

8.

6. DECLARATION
I ...........................................................................hereby declare that the foregoing particulars are true to the
best of my knowledge and belief, and agree to abide by the terms and conditions of the Society, the
loan policy, and variations by the Credit Committee in respect of section (3) above, and any other
future amendments at any time. I hereby authorize the necessary deductions or any other interest
applicable, to be made from my salary as repayment for this loan. I hereby irrevocably authorize the
society to set off at any time all monies held by the society against my indebtedness arising from this
facility now or in future whether several or joint, actual or principal debtor and at any time to
consolidate with out giving notice or receiving notice from me. I also declare that in case the employer
delays the deductions, I will be paying personally to the Society’s bank account every month to avoid
accrued interest until action is taken by the employer. I do also authorize the society to share my credit
information with Credit Reference Bureau.

Applicant’s Signature:..................................................... Date:...................................................

WITNESS NAME (MUST be active member of the society)…………………………......…...............….

ADDRESS……………………………Staff/P.J/P.F /Membership No……………….........…....…..…..

WITNESS SIGNATURE…………………….....……………………………….…………...….........….

7. LOANS HELD IN OTHER FINANCIAL INSTITUTIONS

Name of Bank/Financial Amount Date Granted Repayment Outstanding

Institution Advanced Period Balance

4
8. LOAN CLEARANCE FACILITY

I wish to apply for a Loan Clearance/Offset Facility: Yes No

Please tick the loans you wish to offset

Loan to Offset TICK Loan to Offset TICK

Diamond Loan Refinancing Loan

Development Loan Salary Advance

Education Loan Salary In Advance

Emergency Loan Business Loan

Jipange Loan Personal Loan

Bank Loan from other Bank/Financial Institution Others

NB: For bank loan clearance, attach a certified copy of bank loan statement.

Credit Manager.............................................
9. A. Office Recommendation
(1) Loan Officer................................................... Name...............................................................

Sign............................................................. Date.................................................................
(2) Credit Manager............................................. Name...............................................................

Sign.............................................................. Date..................................................................

(3) Head of BOSA............................................... Name................................................................

Sign.............................................................. Date..................................................................

(4) C.E.O............................................................ Name................................................................

Sign.............................................................. Date..................................................................

B. Credit Committee
We have examined this application in conjunction with the office remarks and have decided as follows:-
(a) Loan approved Kshs.....................Recoverable in ................. installments w.e.f. ......................

(b) Deferred/Rejected due to ....………………………………………………………………....

Credit Committee Minute No. …………………………………. Date ………………………....

Chairman……………..………Secretary…………………………Member ………….....…......

C. Review/Appeal ………………………………….................................................................

Remarks …………………………………………………………………..…...….........…….…
Chairman……………..………Secretary…………………………Member ………….....…......
5
 10. TERMS AND CONDITIONS

The following conditions and terms shall apply:-

i. A member must have contributed deposits and been active for a minimum period of three months for Jipange Loan
and six months for all other loans. A member must have minimum shares of Kshs 20,000

ii. The total deposits of the borrower and those of the guarantors must be equal to or more than the loan applied for.

Guarantors’ loan and deposits must be up-to-date to be eligible.

iii.
Any category of outstanding loan must be cleared before a new loan of the same category is granted.
iv.
No member within the common bond will be permitted to suffer total deductions including savings, loan repayment
v. and interest in excess of two-thirds of his/her basic salary.

A one off commission shall be charged on loans to be topped up.

vi.
No member will be eligible for top up unless he/she has serviced the loan being top up for at least 6 months except
vii. top up on Emergency loan.

New loans will be given subject to the previous loan being regularly paid.
viii.
Total BOSA loans granted or owed to the society shall not exceed four times a member’s deposit savings and in all
ix. cases shall be repayable within the loan’s stipulated period.

In case of any default in repayment the entire balance of this loan will immediately become due and payable at the
x. discretion of the Credit Committee and any sum due to me by way of deposits, interests and salary from the said
employer due to the member will be offset against the balance owed. The member will be liable for any costs
incurred in collection of the loan balance and accumulated interest.

Savings contribution paid in cash or cheque outside the check-off system shall remain in the Society for at least six
xi. months to be considered for lending purposes. Otherwise, a fee will be charged. For members not on check-off
boosted deposits will be considered for loan at the expiry of the 6 months period.

The loan application form must be completed and supported with the most current certified pay slip, copy of
xii. national identity card/ passport.

For personal, Salary Advance, Salary in advance loans, member’s salary must have been received through the
xiii. FOSA account for at least one month.

Bima Loan must be guaranteed by deposits and the maximum loan amount is Kshs 300,000/-.
xiv.
Business Loan-Must have Business account at FOSA, for class B Shares; and for class A shares/Must have FOSA
xv. savings Account and must have run the account for 6 months. The loan is guaranteed by loanee & guarantors’
deposits and collateral which must be valued, charged, comprehensively insured and the Society’s interest noted at
the loanees’ cost.

An application for a loan shall only be considered when the authorized loan application form is used.
xvi.
No member shall be refunded his/her deposit unless he/she has cleared all his/her outstanding liabilities in time.
xvii.
Fees and charges to cover administrative costs shall be paid by the borrower. Such fees and charges will be in
accordance with prevailing SACCO tariffs.
xviii