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PART A-G & K)
four
LOAN INSURANCE (Tick appropriately)Recover from Loan Add to Loan Amount Pay by Cheque
AMOUNT IN FIGURES
TYPE OF THE LOAN
KENYA MEDICAL ASSOCIATION REGULATED NON WDT SAVINGSAND CREDIT CO-OPERATIVE SOCIETY LIMITED
8. Loan insurance is charged on all new Loan applica�ons.
LOAN SERIAL No.
E: REPAYMENT PROPOSAL DETAILS
D: PURPOSE OF THE LOAN (TICK APPROPRIATELY)
(To be completed by guarantors who are members of KMA SACCO. Please read the following statement carefully.)
The amounts of deposits available to be guaranteed are those that are not yet committed to any other person that they have guaranteed.
MODE OF REPAYMENT: (Direct debit/standing order/check off)
F: GUARANTEE
REPAYMENT PERIOD
In considera�on of guaranteeing the above or any lesser amount that may be approved, we the undersigned herewith accept jointly and severally the liability for repayment in the borrower's default. We understand that the amount in default may be recovered as an offset against our shares in KMA SACCO or by a�achment of property or salary and that we shall not be eligible for loans unless the amount in default has been cleared in full.
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NAME KMA SACCO MEMBERSHIP
NUMBER
ID/PASSPORT NUMBER
AMOUNT GUARANTEED
SIGNATURE
KMA SACCO Member's loan application Save regularly, Borrow Wisely & Repay promptly
SECTOR Tick Appropriately 1000 AGRICULTURE
1100 Crop Farming 1200 Animal Production 1300 Agricultural supporting services 1400 Agribusiness
2000 TRADE 2100 Wholesale and Retail 2200 Transport- Purchase of motor vehicle 2300 Hospitality 2400 Foreign Trade
3000 MANUFACTURING AND SERVICING INDUSTRIES 3100 Cottage Industry 3200 Servicing Industry 3300 Information, Communication and Technology
4000 EDUCATION 4100 Education and related services
5000 HUMAN HEALTH 5100 Human health and related services
6000 LAND AND HOUSING 6100 Land 6200 Housing
7000 FINANCE, INVESTMENTS AND INSURANCE 7300 Mortgage Finance 7400 Insurance 7500 Investments
8000 CONSUMPTION AND SOCIAL SERVICES 8100 Utilities 8300 Consumer Durables 8400 Social and communal expenses
(Appraisal)
Payment by (tick) ChequeG: DISBURSEMENT DETAILS
Signature of applicant Date
EFT RTGS
KMA SACCO Member's loan application Save regularly, Borrow Wisely & Repay promptly
H. DECLARATION
I: FOR OFFICIAL USE
J: APPROVAL BY CREDIT COMMITTEE
TOTAL MEMBERS DEPOSITS MAXIMUM LOAN (3 times of deposits)
AMOUNT APPLIED OWN DEPOSITS PLUS GUARANTORS
OTHER SECURITY (give details)
Number of months, if any, the member has defaulted. Is the member's contribu�ons up to date (yes/no)
Is the loan fully guaranteed (yes/no)
AMOUNT RECOMMENDEDMONTHLY REPAYMENT: COMMENTS
Appraised By: Checked By:
We have today examined the above loan applica�on and have decided as follows:
Loan approved (figures): Kshs Repayment period Months
Amount in words
Chairman: Signature Date (Credit committee)
Secretary Signature Date (Credit committee)Comments:
I hereby declare that the foregoing par�culars are true to the best of my knowledge and belief. I agree to abide by the By-laws of thesociety; the loaning policy and any varia�ons by the commi�ee in respect of C and D above.I further declare that I have understood the instruc�ons on the first page of the applica�on form.
Account Name:
Account Number:
Bank Name: Branch:
Other Disbursement Instruc�ons:
GCEO:_______________________________________Signature:_______________________ Date:_____________________
Comments:_____________________________________________________________________________________________
______________________________________________________________________________________________________
Office.
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I/D. No.
I/D. No. ....................................................................................................
