Insert Mushanga

Date…………/………/20………. MUSHANGA SACCO LTD log

Branch:
Account Name:
Account Number:
MSACCO Account:
Address:

MSACCO SERVICES APPLICATION/DECLARATION

I hereby apply for the above mobile banking services. I warrant that the information given above is true
and complete and I authorize you to take any enquiries in connection with this application. I accept and
agree to be bound by the general terms and conditions of use. I agree and liable for all the charges
incurred through the use of this service. I hereby indemnify the bank against all losses which may occur
as a result of my use of service. I understand the Mushanga SACCO ltd reserves the right to decline this
application without giving reasons

Additionally I apply for the mentioned below MSACCO services (Tick where applicable)

1. Allow MSACCO Deposits

2. Allow MSACCO withdraw
3. Allow MSACCO balance Check

Members Name……………………………………………….Signature……………………………………Date………..………………….

FOR BANK USE ONLY

Checked by:…………………..…………………… Authorized by………….…………………………
Title:…………………………….……..……………… Title…………………………………………………….
Signature&Stamp:……………………………… Sinature&Stamp…….…………………………..
Date…………/………/20………. MUSHANGA SACCO LTD Insert Mushanga
log
Branch:
Account Name:
Account Number:
MSACCO Account:

Address:
SMS ALERTS DECLATION
I hereby apply for SMS Alerts service indicated below. I warrant that the information given above is true
and complete and authorize you to take any enquiries necessary in connection with this application. I
accept and agree to be bound by the general terms and conditions of use. I agree and liable for all the
charges incurred through the use of this service. I hereby indemnify Mushanga SACCO Ltd against all
losses, which may occur as the result of my use of service. I understand that Mushanga SACCO Ltd
reserves the right to decline this application without giving reasons
Receive SMS Transaction Alerts on, Receive SMS loan Alerts
Deposits Automatic SMS on Due loan
Withdraws Upon loan Application
Earning Interest Upon loan Disbursement
Earning Dividends Upon loan Repayment
Transfer Upon loan Refund
Standing Order Upon loan arrears

Members Name……………………………………………….Signature……………………………………Date………..………………….

FOR BANK USE ONLY

Checked by:…………………..…………………… Authorized by………….…………………………
Title:…………………………….……..……………… Title…………………………………………………….
Signature&Stamp:……………………………… Sinature&Stamp…….…………………………..
Date…………/………/20………. MUSHANGA SACCO LTD
MUSHANGA SACCO LTD

Insert Mushanga Village/Cell………………………………………………………….…………

log Parish/Ward……………………………………………………………….….
Subcounty/Town Council……………………………………………….
County/Municipality…………………………………….………………..
District/City………………………………………………..………………….
Date………………………………………………………….……………………
The Manager
Mushanga SACCO
Po Box 197 Kabwohe Uganda
………………………………………..Branch
Dear Sir/Madam,
RE: CHANGING/ADDING STATIC DATA ON ACCOUNT
I/we…………………………………………………………………………………………………………hereby request to change my
phone Number/Email/Fax/others (indicate)………………………………………………………………………………………………
On My account Number……………………………………………………………………………………………………………………………
Reason of Change………………………………………………………………………………………………………………………………………

My previous Phone Number/E-mail/Fax/Others (Indicate)………………………………………………………………………

My Current Phone Number/E-mail/Fax/Others (Indicate)…………………………………………………………………………
Signed by the said;
1…………………………………………………………………Signature……………………………………Date……………………………….
2…………………………………………………………………Signature……………………………………Date……………………………….
3…………………………………………………………………Signature……………………………………Date……………………………….
In the Presence of;
Name of officer…………………………………………Title…………………......Signature………………………Date…………………

Approved
Checked by:…………………..…………………… Authorized by………….…………………………
Title:…………………………….……..……………… Title…………………………………………………….
Signature&Stamp:……………………………… Sinature&Stamp…….…………………………..