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COOPPAY STUDENT CARD

APPLICATION FORM
 COOPPAY STUDENT CARD
APPLICATION FORM
BRANCH: DATE: D D M M Y Y Y Y

SECTION A: STUDENT’S DETAILS

First Name: Middle Name:

Last Name: Date of Birth: D D M M Y Y Y Y

Passport
Photo Here Birth Certificate No: Class (Form/Grade):

School Name:

School Physical Address: Street: Building: Floor:

Postal Address: P.O Box: Postal Code: Town:

SECTION B: PARENT/GUARDIAN’S DETAILS

TITLE (Tick Appropriately): Mr. Mrs. Miss Dr. Prof. Others (specify):

First Name: Middle Name: Last Name:

ID /Passport No: KRA PIN:

Mobile No: Email Address:

Nationality: Occupation/ Profession:

Physical Address: Street: Building: Floor:

Postal Address: P.O Box Postal Code: Town:

Parent/Guardian’s Declaration.
I, the undersigned, a parent/guardian to ______________________________________ (student name) hereby apply for the provision of a student
COOPPAY card by the Co-operative Bank of Kenya Limited, to ___________________________________________ (student name). I warrant that the
information given above is true and complete and authorize the Bank to make any inquiries necessary in connection with this application. I confirm that
I have read, understood and accepted to be bound by the stated terms and conditions of use (see overleaf) as amended from time to time.
Parent’s/Guardian’s Signature
Name: Signature: Date:

SECTION C: SCHOOL CONFIRMATION

We hereby confirm that the above mentioned is a bona fide student of ___________________________________________ (Indicate Name of school)
.
Confirmed by: Principal/Deputy Principal
Name: Signature & Stamp: Date:

SECTION D: FOR OFFICIAL USE ONLY: Verification Checklist (Tick Appropriately)

PF NO: ARO CODE:

Branch Maker. Completeness of details confirmed KYC done Card to be processed through BOS

Name: Signature: Date:

Branch Checker Completeness of details confirmed KYC done Card to be processed through BOS

Name: Signature: Date:

Card Business Maker: Completeness of details confirmed Data captured in CMS

Name: Signature: Date:

Card Business Checker: Completeness of details confirmed Application Verified

Name: Signature: Date:

BOS: Completeness of details confirmed Card Processed PIN Processed

Name: Signature: Date:

 COOPPAY STUDENT CARD
APPLICATION FORM

SECTION E: TERMS & CONDITIONS

1. DEFINITIONS
Unless the context requires otherwise, the following terms and expressions, in these conditions; shall be understood and meant to be:-
1.1 “Acquirer” means, a bank or financial institution that processes card payments on behalf of a merchant. The acquirer allows merchants to accept card payments from the card-issuing banks within an
association.
1.2 ‘ATM’ means an Automated Teller Machine, a cash handling device belonging to the Bank or other participating bank(s) or financial institution(s) which accept(s) the card(s).
1.3 ‘Card Transactions’ shall mean any payment made or cash advance obtained by the use of the card at an ATM or a Merchant Establishment, or any other instruction given by the use of card.
1.4 ‘Cardholder’ means the person or assigned Agent of the person who has been rightfully issued a card by the Bank upon request.
1.5 “Contactless Payment” means payments that utilize a technology known as NFC (Near-Field Communication). This allows cardholders to make fast and easy payments with contactless cards and
payment-enabled devices.
1.6 ‘COOPPAY’ refers to the VISA prepaid card issued by the Bank to the cardholder.
1.7 “Issuing Bank” means, also known as issuer, is a bank or financial institution that offers payment cards to consumers on behalf of the card networks.
1.8 ‘PIN’ means the Personal Identification Number as provided to the cardholder by the Bank , for use with and in relation to the card in terms hereof.
1.9 ‘Principal member’ means the person or entity who is responsible for funding a student COOPPAY card.
1.10 ‘The Bank’ means Co-operative Bank of Kenya Limited of P.O. Box 48231-00100 Nairobi and its assignees or agents.
1.11 ‘Transaction Fees’ means amounts (including any fees or commissions) payable by the cardholder arising from card usage under the terms and conditions and includes, without limitation all transaction
fees, service charges, and additional expenses.

2. GENERAL CONDITIONS Email: customerservice@Co-opbank.co.ke, cardholder shall surrender the prepaid card(s) to the nearest
2.1 The student Co-opPay card is neither a credit card nor a cheque cardauthorization@Co-opbank.co.ke, branch of the Bank.
guarantee card and shall not be presented as such. Twitter:@Coopbankenya The cardholder and any supplementary or additional
2.2 The student Co-opPay card is for use only at Co-op Bank ATMs, Facebook: Co-op Bank Kenya (Official) or other channels as cardholder shall immediately pay all amounts owing to the
other Bank Visa branded ATMS and at Visa branded merchant may be advised by -e Bank immediately, quoting the card Bank in connection with the prepaid card (including any
point of sales. number. Where the cardholder is registered on internet additional or supplementary card) together with any interest
2.3 The student Co-opPay card once issued to the cardholder is not banking services (Co-op online), they should immediately accrued.
transferable. utilize the block card option to de-activate a lost/stolen card. The cardholder and any supplementary or additional
2.4 The student Co-opPay card is the property of the Bank and the 4.3 The cardholder(s) shall be liable in respect of any transaction cardholder shall remain liable for any transaction carried out
cardholder undertakes to return the card to the Bank on instruction given prior to receipt by the Bank of notification of using the prepaid card or supplementary or additional card that
demand. such loss, theft or disclosure. is not surrendered to the Bank after termination.
2.5 The card must not be used for any unlawful purpose including 4.4 The cardholder shall provide the Bank with all the information
the purchase of goods or services prohibited by local and in his/her possession about the loss, theft or misuse of a card 6. LIABILITY OF A CARDHOLDER
international law. or the PIN, and any other information the Bank may require to Subject to above condition, cardholders shall be fully liable in
2.6 The principal member will hold the Bank harmless for all facilitate investigations into such loss theft or misuse. The Bank respect of each transaction instruction.
transactions carried by the cardholder. may give the police any information it thinks will be useful in
7. FORCE MAJEURE
their investigations. If the cardholder finds the card(s) which
3. USE OF CARD AND PIN Neither party shall be liable for failure or delay in the
he/she had reported as lost, stolen or at risk of misuse, he/she
3.1 The applicant will be issued with a card and PIN by the Bank’s performance of its obligations under this agreement to the
must not use them. The cardholder shall be required to cut the
branches, or appointed agents and must exercise due care and extent that such failure or delay is caused by matters beyond
card in half and return them to the Bank immediately at the
attention in handling the card including safety and that party’s reasonable control including but not limited to
address shown in condition 6(ii).
confidentiality of the PIN at all times. destruction arising out of war, rebellion civil commotion, strikes,
4.5 The Bank will, as soon as is practicable, replace any lost or stolen
3.2 The cardholder may use the card subject to the terms of this lockouts and industrial disputes, fire, explosion, earthquake
card subject to payment of the applicable replacement charge
agreement to purchase goods and/ or obtain services at any and or other seismic activity, acts of God, flood drought or bad
and any over limit and overdue amounts as at the time of
establishment accepting VISA branded cards. weather, the unavailability or other media or other acts or
collection. All replacement cards will be issued with new card
3.3 The customer must sign the card at the back immediately orders of any government department, council or other
which will be a continuation of the old card account number so
upon receiving it. The card will be valid for the period indicated constituted body. Notice of these circumstances shall be given to
replaced and the conditions applicable to the old card account
on the card and upon expiry; it will be renewed at a fee. the other party as soon as practicable. For so long as
number shall apply thereof.
3.4 All transactions will be billed on the card account and the performance of those obligations is suspended the other party
cardholder is solely responsible for ensuring that there are 5. TERMINATION & CANCELLATION may similarly suspend performance of its obligations.
sufficient funds available for any intended card transaction. 5.1 Action by the Bank
8. AMENDMENT OF CONDITIONS OF USE
The Bank shall withdraw the right of a cardholder to use the
The Bank reserves the right to vary, amend or replace all or any
LIMITS card , cancel or suspend the card, refuse to authorize a card
of these conditions at any time subject to the Bank issuing a
CHANNEL DAILY LIMIT (KES) transaction or refuse to re-issue , renew or replace the card by
30-day prior notice of its intentions to do so to the cardholder.
Co-op Kwa Jirani Agent 40,000/- giving the cardholder a reasonable notice of thirty (30) days
except: 9. INDEMNIFICATION
ATM Withdrawal 40,000/-
i. Where the card is being used for suspicious/ illegal activity; or The cardholder and/or principal member undertakes to
E-Commerce 40,000/-
ii. Pursuant to a court order. indemnify and keep the Bank indemnified against all losses,
KITS 0
5.2 Where the Bank seeks to close the cardholder’s account for costs, and expenses that the Bank may suffer as a result any
Branch POS 200,000/- cardholder claim and against claims arising from or
reasons other than those stated in clause 5.1 above, the Bank
Merchant POS 200,000/- shall inform the cardholder of the reasons why the card account attributable to the loss or misuse (howsoever arising) of ATM
should be closed. Bank’s decisions shall be governed by its card or PIN issued by The Bank to the cardholder.
3.5 Applicable transaction limits are as follows: authorization parameters as may be determined from time to
10. LAW
Cardholder shall contact the Bank for assistance using the time at the Bank’s sole discretion.
These terms and conditions shall be governed and construed
contact details provided in 4.2 should they wish to carry out The funds in a card account closed pursuant to a court order
under the laws of the Republic of Kenya.
transactions beyond the limits specified above . may only be dealt with as the court may direct.
5.3 Termination by the cardholder
4. LOST/STOLEN COOPPAY CARD The cardholder may at any time close the account linked to a
4.1 A cardholder(s) must exercise all due care and attention to prepaid card by notifying the Bank of such intentions in writing.
ensure the safety of the card and the secrecy of the PIN at all The cardholder may terminate use of card by an additional or
times and to prevent the loss of and/or use of his/her card or supplementary cardholder at any time by notifying the Bank of
PIN by any third party. such intentions in writing.
4.2 If a card is lost or stolen, or a card is for any other reason liable 5.4 Consequences of termination
to be misused or the cardholder has any reason to suspect that Upon termination by either the Bank or the cardholder:
the PIN may have been discovered by unauthorized persons, The cardholder and any supplementary or additional
he/she must IMMEDIATELY notify the Bank by Telephone: cardholder shall not use and shall not be entitled to use of the
+254 020 327 6000 or 0703 027 000, prepaid card or any benefits in connection with the prepaid
Whatsapp:0736690101, card; The cardholder and any supplementary or additional
 COOPPAY STUDENT CARD
APPLICATION FORM

CHARGES
NO. ITEM CHARGE (KES)
1. Card Issuance Charges (Smart Cards) 500
2. Card Renewal/Replacement Charges 500
3. Cash Withdrawal (Co-op ATMS) 30
4. Cash Withdrawal (Other Bank ATMs) 200

5. Cash Withdrawal (Agents) Tiered as per agency tariff depending on amount withdrawn,
mimimum charge is KES 50/-
6. Payment of Goods/ services (Purchases) FREE
7. Cash deposit (Co-op Kwa Jirani Agent) FREE
8. Prepaid card loading (Over the Counter, ATM, Agents) FREE
9. Prepaid card loading (Via Mobile) Mobile operator fees apply
10. Prepaid card loading (Via Internet Banking) FREE
11. SMS Alerts FREE
12. Balance Enquiry (Co-op ATM) FREE
13. Balance Enquiry (Via Mobile) Mobile operator fees apply

14. Balance Enquiry (Co-op Kwa Jirani Agent) Kes 10.00

15. Viewing Mini Statement (Via ATM) FREE
16. Viewing Mini Statement (Via Mobile) 20
17. Viewing Mini Statement (Co-op Kwa Jirani Agent) 20

The above charges are subject to excise duty. The excise duty is subject to government levies as gazetted by the government from time to time currently it is 20%

Supporting documentation to be attached:

1. Copy of ID/Passport of Parent/Guardian
2. Copy of KRA PIN of the Parent /Guardian
3. Copy of student birth certificate
4. Student ID/Student Admission Letter

I/We having read and understood the General Terms and Conditions and Data Privacy Statement available at the Branches or on the Bank’s
website www.Co-opbank.co.ke hereby [authorize] /[do not authorize] (tick whichever applicable) the Bank to use my/our contact details
to send information about products and services including but not limited to offers and promotions which may be of interest to me/us. The Bank
may do this by phone, post, email, text or through other digital media.

I/We confirm having understood that my/our personal information provided in this application form shall be processed in accordance with the
provisions of the Data Protection Act, 2019, and where applicable the General Data Protection Regulation (EU) 2016/679 or all other applicable
laws as may be amended from time to time.

I/We confirm having read and understood the General Terms and Conditions and Data Privacy Statement available at the Branches or on the
Bank’s website www.Co-opbank.co.ke or such other websites as the Bank may designate as its official website from time to time on this day
_______________ month ________________ year ______________ .

Please sign below to indicate your understanding and acceptance of the terms and conditions of use of your COOPPAY student card

Parent’s/Guardian’s Signature

Name: Signature: Date:

Co-operative Bank House Haile Selassie Avenue | P.O BOX 48231, 00100,
NAIROBI TEL: +254 020 327 6000 or 0703 027 000, Whatsapp: 0736690101
EMAIL: customerservice@Co-opbank.co.ke
The Co-operative Bank of Kenya is regulated by Central Bank of Kenya