Serial No.
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LOAN APPLICATION AND AGREEMENT FORM
A. APPLICANT’S PERSONAL INFORMATION
Applicant’s Name; Loan Number;
Member Number; ID/No;
Amount Applied for;
Postal Address Mobile No. Email
Physical address Town; Estate; Street; House Number;
Marital status Single Married Widowed Other
Number of dependents;
B.EMPLOYMENT DETAILS
Applicant’s Employer; Postal Address;
Physical Address; Mobile No.
Designation; Retirement Date; Provide Proof of other income if loan term extends beyond this date
Employment Terms Permanent Casual Contract Other (specify)
Assets Owned Give three main ones
IF SELF EMPLYED
Attach 6 months bank statement , 1 year cash flow forecast and any other documents as may be required by management
Type of business; Years of operation;
C. LOAN PARTICULARS
LOANS TYPE; Normal Emergency Other(specify)
(attach 4 latest original pay slips or as may be required)
Purpose of loan (attach supporting documents)
Amount applied for in figures; Repayment Period; Months
Amount applied for in words;
NB :Alteration on amount applied above will not be allowed
LOAN IN OTHER BANKS /FINANCIAL INSTITUTIONS
Name of the Bank /Institution Amount advanced Date granted Repayment Period Outstanding balance
D SECURITY DETAILS
I offer the following security
Salary Deposit and Saving Guarantors
Conditions
Provide a minimum of 3 guarantors who have not guaranteed active loans.
The applicant’s 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
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 the full implication of loan guarantee
REPAYMENT GUARANTEE
We, the undersigned hereby accept jointly liability for the repayment of this loan in the event of the borrower’s
default. We undersigned that the amount in default may be recovered by an offset against our deposit or attachment
of our property, salary, FOSA deposits and other property owned by us.
Member Name Loan outstanding Kshs Deposit Kshs ID Number Signature
Number
1
2
3
Where collateral or any other form is used as security, provide details below.
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
Official use only.
Deposits and outstanding loans at………………………………………………………………………
Balance Monthly Repayment
1.Normal Loan
2. Emergency Loan
3. Other
TOTAL
Deposit
E LOAN AGREEMENT AND DECLARATION
In consideration of Ambassadors of Peace (the society) granting me the amount of Loan herein applied for or as may be
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 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 is done in full.
This instruction shall remain irrevocable until the loan amount herein has fully 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 to entering this agreement or I have opted to service the loan through
other mean 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 or as advised by the
society , in favor of the society and I shall not revoke the said standing orders while the amount herein remain unpaid.
5. I understand that the society may, at its sole discretion treat as a breach of loan condition should I revoke the
instructions in paragraph 3 above without obtaining the prior written consent of the society.
6. In the event that my current employment is for whatever reason terminated while the loan herein not full 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 services of my present employer, and sum of money due to
me is necessary 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 shares 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 serving 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 claim 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.
F. 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 pertaining 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 rights to determine, change the rate of interest and or the basis on which it is calculated.
d) The loans repayment frequently 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 fees and charges will be in
accordance with prevailing Society tariff.
G. DISBURSEMENT
Applicant’s signature ____________________________________________Date ________________________________
Name of witness ___________________________________________S/No_______________Signature______________
H. APPROVAL
FOR OFFICIALS USE ONLY
___________________________________________________________________________________________________
Loan /Cheque amount approved KES_____________________________________________________________________
CreditOfficer:Name;____________________________Signature _____________________Date __________________
Hon Sec: Name;______________________________ Signature _____________________Date __________________
Treasurer:Name;_______________________________ Signature _____________________Date __________________
CEO : Name;_______________________________ Signature _____________________Date __________________
