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VITENDO GATEWAY SAVINGS AND CREDIT CO-OPERATIVE SOCIETY

Mission: Empowering Members Build Financial Freedom Cargo Bay 7220 N. Lindbergh, Suite#240, Hazelwood, Missouri, 63042 Telephone: 314-252-0488, info@vitendogatewaysacco.com, www.vitendogatewaysacco.com Our Core Values: Customer Service, Teamwork, Integrity, Professionalism and Equity Vision: Foster and Promote Growth & Development of Members for their Economic Welfare

CONFIDENTIAL

Loan Application and Agreement Form

Name of Applicant

Membership Number

Loan Type

Document Check List (Tick as Appropriate) 1. Application form completed and duly signed 2. Application form signed by guarantors 3. Latest Pay Slip/ Statement of Income attached 4. Any bank deposit slip in case of cash clearances 5. Fee Structure/ Invoice for School Fees Loan 6. Cover letter for Emergency Loan 7. Deposit alteration form completed

Loan Application Form Vitendo Gateway Sacco

A: PERSONAL INFORMATION (Complete All Fields) 1 2 3 4 5 6 7 8 9 10 Applicants ID/P.P Number Applicants Current Address Applicants Telephone Number Name of Employer/ Host/ Relative Employer/ Host/ Relative Address Employer/ Host/ Relative Telephone # Monthly Expenditure $ Position in Employment Duration with Employer (Months/Yrs) Position in Sacco

B: LOAN APPLICATION AND REPAYMENT I herby apply for a loan of USD . Amount in words ... Repayable within a period of . Months paid in installments of USD . each month (excluding interest) commencing on... C: PURPOSE FOR WHICH THE LOAN IS APPLIED FOR
(in case of several uses of the loan state the amount for each)

1) . 2)... 3) . 4) .. D: SECURITY OFFERERD FOR THE LOAN 1. 2)... 3. 4) .. I HEREBY AUTHORIZE ANY OR ALL OF THE ABOVE SECURITIES TO OFF-SET MY OUTSTANDING LOANS IN CASE OF DEFAULT. Applicant ... Date
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Loan Application Form Vitendo Gateway Sacco

E: DECLARATION I hereby declare that the foregoing particulars are true to the best of my knowledge and belief. I agree to abide by the by-laws of the Sacco, the loan policy, and any variations by the Credit Committee in respect of Section B above. I hereby authorize the necessary allocations including monthly interest and any penalties as may apply to be made from my repayments of this loan. I declare that I am not indebted to any other loan agency (except as listed herein) either as a borrower or endorser. Applicants Signature... Date Witnessed By: Name ... Signature Phone# Date ... Member # F: REPAYMENT GUARANTEE We, the undersigned, hereby accept jointly and/or severally liability for the repayment of the loan in the event of the borrowers default. We understand that the amount in default may be recovered by an offset against our shares in the Sacco or by an attachment our property or salary, and that we shall not be eligible for loans unless the amount in default has been cleared in full. G: GUARANTORS NAME
MEMBER # SHARES $ LOANS $ PHONE # SIGNATURE

TOTALS

Shares .. * 3 = . Minus Loans . Minus Guarantee. Minus Loan Applied .. = USD (Must Be more than C)

I: FOR OFFICIAL USE ONLY Applicants total deposits USD . Total Loan(s) Outstanding USD
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Loan Application Form Vitendo Gateway Sacco

Amount currently requested USD . New Total Loans will be USD

Eligibility Calculations: Total Deposits: .*3 = USD Applicants present monthly Net Income USD .. *0.66 = USD Total Monthly payments to the Sacco including payments on loan requested USD (Must NOT Exceed the amount Above)

The Guarantors cover the loan amount: YES

NO

I certify that the application IS

IS NOT

within the Sacco Rules.

If NOT Explain

Loans Officer Name: . Signature.. Date

Approval By Office Manager/ Treasurer Officials Name: .. Signature...... Title.. .. Date..

FOR ACTION BY THE CREDIT COMMITTEE Loan Approved USD .. Recoverable in months installments at an interest rate of % per month on a reducing balance.
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Loan Application Form Vitendo Gateway Sacco

Indicate the reason for DEFERAL or REFUSAL by ticking the appropriate box. Reason(s) Loan Deferred Incomplete information/ insufficient support documentation Time Limits Renegotiate Loan Terms or Purpose Inadequate Funds to meet demand Others Specify.

Reason(s) Loan Rejected Inability to pay or Bad repayment history Loan not in required proportion to shares Un-cleared Outstanding Loans Excessive Loan frequency Lack of Adequate/Appropriate Guarantee or Security In Sufficient Membership period Ineligible Purpose Others Specify Ref Number Date ... Chairman ... Member..
Affirmation To be signed by all CMC Members and witnessed by the Supervisory Committee Officials

NAME 1. 5| Page

POSITION

SIGNATURE

DATE

Loan Application Form Vitendo Gateway Sacco 2. 3. 4. 5. 6. 7. 8. 9. 1 0.

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