DC 4.0 Loan Application form
LOAN APPLICATION FORM
Name of applicant
Residential Address
Membership No.
Location of Project/business
Savings Account No.
Amount of Loan applied for Shs……………….. (Amount in words)……………………………………………………............
Purpose for which the loan is required…………………………………………………………………………………………….
Date when the loan is required…………………………………………………………………………………………………….
Source of the loan repayment……………………………………………………………………………………………………...
Securities offered:
Name of Security
location/ department
Appr.Value.(in Ushs)
1………………………………………….
…………………………………………..
……………………………
2………………………………………….
…………………………………………..
……………………………..
……………………………………………
………………………………………….
………………………………
No. and Value of Shares in the
Society………………………………………………………………………………………………..
Balance on my Savings Account deposits in the Society
(Shs)……………………………………………………………………….
Guarantors: I/we, the understand accept that the loan applicant be granted a loan by the Cooperative Society and hereby
agree to repay from our own sources including our savings in the society, the total amount of the loan owned by the applicant/
borrowed to the Cooperative society if the applicant fails to repay the loan granted by the society by the time it is due.
1. Name………………………………..Membership No……………..Savings A/c No………………….Signature……………
2. Name………………………………..Membership No………………Saving A/No……………………Signature……………
I understand to fully repay the loan applied for with interest thereon on the due agreed upon with the society. I also authorized
the society to deduct from my Savings Account, Share Capital or to sell my assets pledged as securities for the loan without
any hindrance from me or anyone else to recover any amount of the loan that I will have failed to pay
Signature of applicant……………………………………….Thumb print……………………...Date………………………….
I agree with and hereby give permissions to my spouse to borrow from the society Shs…………………………………..
(Amount in words)………………………………………………………………………for the purpose of …………………
………………………………………………………………………………and to pledge the securities mentioned above.
Name and Signature of spouse………………………………………………Thumb print…………………….Date……………
(Borrower’s Spouse)
Verified and recommended by LCI Chairperson (Name, Signature and Stamp):
Name………………………………………………Signature……………………………Official stamp………………………
FOR OFFICIAL USE ONLY
SOCIETY MANAGEMENT
Date member joined the society………………………………………Date application received ………………………………
Value of shares in the society (Shs)……………………………………Savings balance in the society (Shs)…………………
Loans officer’s assessment Report on the site visit…………………………………………………………………………….
………………………………………………………………………………………………………………………………….
Has the applicant ever borrowed from the society?......................................................................................................................
If yes: what is his / her repayment history?...................................................................................................................................
How is the applicant’s savings record in the society’s? Explain………………………………………………………………..
…………………………………………………………………………………………………………………………………..
Recommendation by the Loan officer…………………………………………………………………………………………..
Signed by the Loans Officer………………………………………
Date ………………………………….
Recommendation by the accountant………………………………………………………………………….
Signed by the Accountant………………………………………….Date……………………………………
Recommendation by the manager………………………………………………………………………………
Signed by the society manager……………………………………Date…………………………………
LOANS COMMITTEE:
Decision by the loans committee………………………………………………………………………………………..
…………………………………………………………………………………………………………………………..
Minute number………………………………Date……………………………………………..
Signed Chairman/ loans committee…………………………………………………Date…………………………………
Committee members
1.
Name……………………………………………………Signature……………………Date………………..
2.
Name………………………………………………….... Signature……………………Date………………
3.
Name…………………………………………………….Signature…………………..Date……………….
4.
Name…………………………………………………….Signature……………………Date………………
5.
APPENDIX 5
THE REPUBLIC OF UGANDA
LOAN AGREEMENT (Individual)
THIS LOAN AGREEMENT is made this………………………day of…………20………..BETWEEEN……………
SACCO, P.O BOX……………………. (Hereafter called the LENDER)
AND………………………………………………………………………………………………………………………
Of…………………………………………………………….. (Herby called the BORROWER)
WITNESSETH:
WHEREAS the LENDER is desirous of advancing / lending money to the BORROWER and WHEREAS the BORROWER
is desirous of borrowing the money from the LENDER, the following are terms and conditions agreed upon by both parties:
25. The LENDER hereby lends the BORROWER as a principal sum of
Ushs……………………………(Shillings…………………………………………………………………………
………………………………………………………………………………………………………………………
……)for a period of ……………Months with effect from the……………………..day of……………
20………..to be repayable to the LENDER as, principal and interest thereon at the rate of………………………
% per month on the outstanding balance.
26. The said BORROWER shall pay a loan commitment fees of…………..% of the principal sum.
27. The said BORROWER shall have a grace period of…………months in which only interest shall be paid to the
LENDER
and the principal and interest in…………………….equal instalments, henceforth paying the last
Instalment on before the………………..day of……………..20……………………..
28. Without prejudice to the provisions above, it is hereby agreed between both parties that in the event of the
BORROWER failing to pay as agreed herein, the BORROWER shall be liable to a penalty of…..% per month
in default in addition to the normal interest rate changed calculated on the outstanding loan balance from the date
Of default.
29. The BORROWER shall use the money lent by the LENDER for …………………………………………… in
accordance with the purpose stated in the application form, duly signed by the BORROWER.
30. The BORROWER shall not divert the loan for any other purpose other than the one applied for and
acknowledged by him / or her without the written consent of the LENDER.
31. Unless otherwise agreed where the BORROWER diverts the loan for any other purposes, other than the one
herein above acknowledged, and agreed or fails to pay any instalment on time, the LENDER may at any time
thereafter demand for payment of the whole amount of the principal and interest thereon due without following
the repayment schedule thereto.
32. The
BORROWER
herby
surrenders
to
the
LENDER
……………………………………………………………………………………………………………
situated………………………………………at…………………………………as security.
33. The BORROWER is hereby presenting…………………………of…………….…………account
number………………………as a GUARANTOR who has consented by appending his/her signature hereto as
a GUARANTOR.
34. It is hereby agreed between both parties that the LENDER will keep the record of this transaction.
35. In the event of the BORROWER’s failure to pay any of the instalment or the whole principal and
interest at the agreed time, the LENDER shall recover the aforesaid instalment or the whole principal or
the whole principal and interest from the GUARANTOR. In case of short fall, the LENDER shall
consequently be free to seize both the GUARANTOR and or the BORROWER’s shares in the
cooperative society.
PROVIDED that such security shall be sold to the highest bidder at the time of sale and after the
LENDER has
realized the loan plus the accumulated interest and other costs of the sale and any other
expenses incurred by the LENDER during the recovery process, the LENDER shall handover the balance
if any to the BORROWER.
36. Agreed up on loan repayment schedule:
1st Instalment of Ushs…………………………………to be paid on…………………………………
2nd Instalment of Ushs………………………………....to be paid on………………………………...
3rd Instalment of Ushs…………………………………to be paid on…………………………………
4th Instalment of Ushs………………………………....to be paid on………………………………...
5th Instalment of Ushs…………………………………to be paid on…………………………………
6th Instalment of Ushs………………………………....to be paid on………………………………...
7th Instalment of Ushs…………………………………to be paid on…………………………………
8th Instalment of Ushs………………………………....to be paid on………………………………...
9th Instalment of Ushs…………………………………to be paid on…………………………………
10th Instalment of Ushs………………………………....to be paid on………………………………...
11th Instalment of Ushs…………………………………to be paid on…………………………………
12th Instalment of Ushs………………………………....to be paid on………………………………...
NAME……………………………………………………………..
TITLE………………………………………………………………
SIGN…………………………………………………………………
For and on behalf of ……………………SACCO
The LENDER
NAME……………………………………………………………….
TITLE………………………………………………………………..
SIGN………………………………………………………………….
BORROWER
GURANTEED BY:
Name
1.
…………………………………………………..
Signature
……………………………………………
SPOUSE/GUARANTORS
2.
…………………………………………………..
……………………………………………
GUARANTOR
3.
…………………………………………………..
……………………………………………
GUARANTOR
WITNESSED BY:
Name
Signature
1. …………………………………………….
…………………………………….
Witness
2. ……………………………………………..
…………………………………....
Witness
3. ………………………………………………………………………………………….
Witness
All in presence of:
ADVOCATE
DRAWN BY:
M/S…………………………………………………
P.O BOX………………….DISTRICT