Derric Joyluck 22

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JOY LUCK EMPOWERMENT SERVICE(C.B.O).

P.O BOX105 -60100


EMBU
LOAN/ADVANCE APPLICATION
PERSONAL DETAILS
NAME…………………………………………………………………………………ID NO:…………………………………………
Postal Address……………………………………………………………… Mobile No……………………………………………
Next of Kin:………………………………………………………………….. Contact………………………………………………
Physical Address……………………………………………………………….Nature of Business …………………………
Village/ Estate ………………………………………………………………... Sub location:…………………………………..
Chief Guarantor:
Name :………………………………………………… ID ………………………...Sign………………….. Date…………………..
My source of income are ……………………………………………………………………………………………………………….
I………………………………………………………………………..Wish to apply for………………………KSH………………….
Amount in words ………………………………………………………………………………………………………………………….
Payable within a period of …………………………………Months (s) at interest rate of…………..%Per month
Account number ………………………………..
LOAN ADVANCE GUARANTEE
We the undersigned acting as guarantors to the above facility /loan on this application form
hereby accept jointly and severally liability for the facility………………………………………in the event of
borrowers default I authorize the office to propose pledged collateral as security and dispose them
to gather with my savings and any other borrows.
GUARANTORS
(1) Name………………………………………………………………………..ID NO: ……………………………………………….
Mobile No:………………………………………………………………..Offered savings:………………………………….
Sign :………………………………………………………………………Date:…………………………………………………..
(2) Name:…………………………………………………………………….ID NO:…………………………………………………...
Mobile No:………………………………………………………………Offered savings…………………………………….
Signature………………………………………………………………….Date……………………………………………………..
I declare that I shall commit myself to repaying the granted loan including interest plus other
group charges Applicant signature ……………………………………Date…………………………………….

FOR OFFICIAL USE ONLY


The loan / advance approved is Ksh ………………………….. And is to be paid with………………..months
At equal installment of Ksh………….. ……….Advance: ……………………………………
I have offered the following as my loan security.

NAME OF THE ITEMS SERIAL NO.


1……………………………………. ………………………………………….
2……………………………………… ………………………………………….
3………………………………………. …………………………………………..
4……………………………………….. ……………………………………………..
5……………………………………….. ……………………………………………..
6………………………………………… ……………………………………………...
7…………………………………………. ……………………………………………….

Group official
Chairperson NAME……………………………….ID NO………………...MOBILE NO………………...SIGN…………...
Secretary NAME…………………………………...ID NO………………...MOBILE NO………………...SIGN…………...
Treasurer NAME:…………………………………..ID NO………………...MOBILE NO…………………SIGN……………
Office NAME:…….................................ID NO…………………MOBILE NO……………..SIGN…………

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