Emergency/Haraka/Education/Loan Application

EMERGENCY/HARAKA/EDUCATION LOAN APPLICATION AND AGREEMENT FORM
PART A: PERSONAL DETAILS

First Name

Last Name

ID No.

Membership No.

Name to Appear on Cheque

Business Name

Postal Address (P.O Box No.)

Town

Post Code

County

Location

Mobile Number

Date of Birth

Email *

IF EMPLOYED INDICATE EMPLOYER, NAME, PHONE NUMBER, ADDRESS)

Total Saving Contribution (Kshs.)

As at

Breifly describe your main income generating activities

What are your monthly average expenses in Kshs.?

How much loan are you applying for? (Kshs.)

Length of Loan

How much loan are you servicing on ‘normal loan’? (Kshs.)

How will you use the loan applied for?

Kindly provide a detailed breakdown of the use(s) of the loan

No of Employees in the last 12 months

Securities - List Guarantors' names and contacts

What measures to be taken if business not to plan - List items and values

List the full details of at least two contact persons

Applicants Signature

Date

I hereby declare that the foregoing particulars are true to the best of my knowledge and belief and agree to abide by the by-laws of the society, the loan policy, and any variations deemed appropriate by the credit committee. I also allow CHESS to verify my loan history with CRB as part of loan appraisal and hereby submit KES 100/= towards the verification.

Phone