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GUARANTORS
Guarantor 1
SURNAME FIRST NAME OTHER NAME
I AMOS CHESEBE CHEPYAKAN of ID No. 5645533
Tel No # 0724218918 Box No # 178 Post Code 50200
Town BUNGOMA Email County BUNGOMA
Constituency
MT. ELGON Ward
CHEPTAIS
2506 6204
Location Sub-Location Year of Birth 12/31/1958
Employer Name Employer Tel. No. Employer Email
NULL
Employee No Employer Postal Address
Employer Postal NULL
Code

(Also known as the guarantor) hereby acknowledge that am bound to the Higher Education Loans Board in the sum of amount equivalent to
what the Board shall grant to (ALLAN CHEPYAKAN) in this and Subsequent applications within the course duration as loan under the
agreement together with interest thereon, which amount I shall repay to HELB in the event the loanee fails to honor his/her obligation of
repaying the same to the Board as from the prescribed time. The loanee will notify me of the amount granted to him/her after the award is
made. This bond is conditioned to be void only after full repayment by the loanee.
Guarantor 1 Signature and Date Advocate/ Magistrate Signature, Date , Official Stamp

Guarantor 2
SURNAME FIRST NAME OTHER NAME
I MARY CHEMTUI CHESEBE of ID No. 2098699
Tel No # 0746356193 Box No # 178 Post Code 50200
Town BUNGOMA Email County BUNGOMA
Constituency
MT. ELGON Ward
CHEPTAIS
2506 6204
Location Sub-Location Year of Birth 12/31/1960
Employer Name Employer Tel. No. Employer Email
NULL
Employee No Employer Postal Address
Employer Postal NULL
Code

(Also known as the guarantor) hereby acknowledge that am bound to the Higher Education Loans Board in the sum of amount equivalent to
what the Board shall grant to (ALLAN CHEPYAKAN) in this and Subsequent applications within the course duration as loan under the
agreement together with interest thereon, which amount I shall repay to HELB in the event the loanee fails to honor his/her obligation of
repaying the same to the Board as from the prescribed time. The loanee will notify me of the amount granted to him/her after the award is
made. This bond is conditioned to be void only after full repayment by the loanee.
Guarantor 2 Signature and Date Advocate/ Magistrate Signature, Date , Official Stamp

Applicant's Personal Bank Details(Attach a copy of bank account card)

Bank Name Branch Name Account No.
KCB Kitale 1272590069

Banks Official Confirmation

Official's name......................................................................Signature .........................................
Official Stamp ..................................................................Date.............................................

CAUTION
Do not leave your Loan Application Form at the Bank

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