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GROUP MEMBER LOAN FORM

Date: Type of Application: New Loan Repeat Loan

Number of Loans: Amount Applied:

Type of loan applied:

APPLICANT’S INFORMATION

PERSONAL DETAILS

Title: Mr./Mrs./Ms./Dr./Prof./Hon. Other (Please Specify)

First Name Middle Name: Surname:

Date of birth: Gender: Male Female

Nationality: National ID/ Passport No: KRA Pin No:

Marital Status: Single Married Divorced Separated Widowed

Present Residence (Location or Estate):

Present Residence Duration of Ownership

(Location or Estate) occupation

RESIDENCE 100% Owned Under Mortgage Rented

BUSINESS 100% Owned Under Mortgage Rented

Describe your source of income:

If agriculture please state size of lan :

HOW CAN WE REACH YOU?

Mobile Number: Other Number:

Email Address: Office Number:

Postal Address: Postal Code: Town:

Next of Kin name: Relationship:

National ID/ Passport No:

Postal Address: Postal Code: Town:

Mobile Number: Email Address:

BUSINESS DETAILS (TICK APPROPRIATE

Organization Type: Sole-Proprietorship Partnership Limited Liability Company

Informal Body (e.g. Registered): Group School Trust

Name of Business/ Company/ Group (As per Registered Certificate):

Nature of Business:
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Gross Income Band (KES): Below 50K [ ] 50-200K [ ] 200-600K [ ] 600K-1M [ ] Above 1M [ ]
Certificate of Registration/ Incorporation No.:

Postal Address: Postal Code: Town:

Mobile Number: Office Number: Email Address:
Website (If applicable): Business Location (Town/ Shopping centre/ Plot/ Street/road):

GROUP DETAILS

Group Name:

Group Registration Number:

Date of Formation: Postal Address:

Postal code: Town: Physical address:

FINANCIAL INFORMATION
Weekly income from business: Weekly expense from business:

MONTHLY INCOME & EXPENSE FROM BUSINESS

INCOME EXPENSES
1.
2.
3.

BUSINESS BALANCE SHEET (THAT IS SUBJECT TO LOAN)

ASSETS LIABILITIES
SHORT TERM SHORT TERM
Cash on hand: Creditors:
Cash in banks: Bank Loans:
Debtors: LONG TERM
Stock: Bank loans:
LONG TERM Other Liabilities:
Total Fixed Assets: Capital
Other Assets:
TOTAL ASSETS: TOTAL LIABILITIES:

FINANCIAL INFORMATION
Purchase price/
Product Selling Price Production price Gross Profit Margin
1.
2.
3.
4.
Average

Average Project on previous loan application

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NET HOUSEHOLD BUDGET (MONTHLY)

MONTHLY INCOME MONTHLY EXPENSE

Housing:
Borrower (Net Salary):

Spouse (Net Salary): School Fees (average per month):

Pensions: Food

Transportation / Vehicle
Business (Overleaf):

Other Businesses: Utilities (total):

Other Income: Other debt repayments:

Total household income: Total Expenses:

THE BORROWER’S PLEDGE

I have read, understood and agreed to abide by the Loan Agreement (herein the “Agreement”) which has
been fully explained to myself, in consideration of the loan or loans advanced to myself by FCL. I irrevocably
assigns all rights, title and interest in the assets listed below (“the Assets”) to Fortune Credit Ltd.I have read,
understood and agreed to abide by the Loan Agreement (herein the “Agreement”) which has been fully
explained to myself, in consideration of the loan or loans advanced to myself by FCL. I irrevocably assigns all
rights, title and interest in the assets listed below (“the Assets”) to Fortune Credit Ltd.

Asset Description Amount

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Name: Signature: Date:

PREFERRED LOAN DISBURSEMENT METHOD

Bank Cheque Registered M-Pesa No.
BANK DETAILS
Account Name:

Account No:

Bank Name:

Bank Branch:

Mpesa Telephone No:

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Loan Request Details

Amount applied for in figures:

Amount applied for in words:

Purpose of the loan:

Repayment Period: Months Repayment Amount (Kes):

ASSOCIATION/ GROUP APPROVAL

On behalf of the above referred Association/ Group and its members, I/we hereby affirm (1) that the Borrower is
a member / employee of our Association/Group or Institution, (2) that the Association/ Group or Institution has
approved this loan, 3) that the members of the Association/ Group or Institution have physically inspected the
assets listed below, (4) that the members of the Association/ Group have determined that all the Assets listed
belong to the borrower, and that the parents/spouse/partner named above has consented and agreed to this
loan.

SIGNED BY THE ASSOOCIATION/ GROUP OFFICIAL (Use full name only, no initials)

Amount approved KES:

Name Date Position Signature

1.

2.

3.

4.
5.

Applicant’s Name: Signature: Date:

GROUP GUARANTEE
THE BORROWER’S
For purpose of this guarantee, the borrower shall be defined as undersigned individuals, each one a member
of the group (herein “G”) named:

BORROWER’S GUARANTEE
This group guarantee agreement is between the undersigned borrowers and FCL, a registered company. In the event
of any borrower’s default as defined in the loan agreement, all borrowers agree to be personally liable for repaying
FCL. FCL is authorized to deduct amounts from any borrower's Loan Security Fund (LSF) account to fulfill these
obligations.
Each borrower pledges both business and personal assets, as listed in the loan agreement, to secure the loan's
repayment. If any borrower defaults, FCL may seize and sell the pledged assets without further notice and use the
proceeds to cover any outstanding debts. Any excess funds from the sale will be returned to the defaulting borrower.
This guarantee binds the borrowers' heirs and representatives in case of death, and the pledged assets cannot be
used as collateral for any other loan during the loan term.
The agreement does not override any previous agreements, and all borrowers confirm their understanding and
acceptance of these terms.
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SIGNED BY ALL GROUP MEMBERS

Name (BLOCK CAPITALS) ID. No. Tel no. Signature

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

Disclaimer: If there are additional group members, kindly attach an extra sheet to ensure that all members are
accounted for.

LOAN AGREEMENT
This is a Loan Agreement (herein the “Agreement”) between FCL , a limited liability company, registered under
the companies Act Cap 486, of P.O BOX -------------- Nairobi, its successor and assigns, ( herein referred to as
“FCL”)and the undersigned individual (herein referred to as “Borrower”). The borrower hereby agrees to repay
the entire loan principal, service charges and penalties in accordance with the terms described below. The
borrower hereby represents and warrants that he or she is a member/ employee of the association/ group
named above. The borrower has read this agreement, understand the terms and conditions contained herein,
and have agreed to abide by the same. In consideration of the loan extended to the borrower by FCL and
formalize in this agreement, the undersigned the borrower willingly enters into this agreement.

Applicant’s Name: Signature: Date:

THE SCHEDULE (TO BE FILLED IN BY CREDIT OFFICER)

Loan Amount (KES): Term: Weeks Months Interest Rate %:

Repayment Frequency: Daily Weekly Monthly Repayment Amount:

Penalty Rate %: Proposed 1st installment:

Proposed last installment:

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1. This loan may be prepaid, without penalty, by paying the outstanding loan balance, plus any service charges and penalties due if a payment is late. An additional penalty will be charged on the
overdue amount at the rate described in the schedule above.

2. Fees and commissions to be recovered after loan approval - % processing, MPESA fee(as per tariff if sent via phone), guarantee G indemnity G kes.
/= chattels mortgage registration fees.

3. Proceeds from the loan shall only be used for the business (s) of the borrower as described in the borrower’s loan Application, which is incorporated into this agreement by reference.
4. The borrower agrees to make deposits: in the amount Kes --------------------------------------------------------------------------------------------- Into a personal Collateral

account held by FCL during the entire term of the loan.

5. An “Event of Default” shall be defined as

a. Missing single loan payment or any part of such payment;
b. Missing single Collateral deposit or any part of such deposit;
c. The use of loan proceeds for any purpose other than those as described in the loan application;
d. The movement of business location, liquidation of substantially all business assets, or other substantial changes affecting the business, without prior written notice to and consent from the
association/group and FCL
e. Any material changes in the facts and circumstances represented in the loan Application; or
f. The death of the borrower.

TERMS AND CONDITIONS

Group Loan Terms
These Terms and Conditions governs the opening and general dealing with group loan form opened 16. All members agree to notify FCL immediately of any unauthorized activity or suspected
with Fortune and constitute the agreement between Fortune and the Customer. fraud related to the loan.
Abbreviation:
“FCL” means Fortune Credit Limited, or Fortune “AML” 17. In order to be eligible for a group loan from FCL, the group must have a minimum of five
means Anti- Money laundering. (5) members and a maximum of twenty (20) members. All members must be permanent
“GTC” means General Terms and Conditions. residents of Kenya and of legal age.
“P.I.N” means Personal Identification Number. 18. The group must submit a loan application to FCL and all members must sign as
“KES” means Kenyan Shillings, the official currency of Kenya. “G” guarantors to the loan agreement. FCL have to conduct a credit check and other due
Named- means group member. diligence before approving the loan.
19. The loan amount and repayment terms will be determined by FCL and the group. The
Definition:
loan amount cannot exceed the total amount that each individual member is able to repay.
“In the event of default” when the borrower fails to pay the loan amount, service charge/penalties and The loan must be repaid according to the agreed upon repayment schedule, which will
enforcement costs. include the amount of each installment, the date of payment, and the interest rate.
“Abide by” follow or comply with.
20. The FCL has the right to penalize late payments by charging additional interest and/or
“Advance notice” notification in advance of an event or action.
fees.
“Assign and transfer” give a right, title, or interest of an asset to another person or entity. “Event of default” 21. If any of the members of the group defaults on the loan, the other members of the group
when the borrower fails to fulfill the obligations in the loan agreement. “Possession” the act or right of
are responsible for repaying the loan in full. FCL has the right to take legal action.
taking or holding property in one's control.
22. The loan security required for a group loan will depend on the amount of the loan and the
“Proceeds” the income or profit made from a sale or other transaction.
creditworthiness of the group and its members. FCL will require collateral for the loan, such
“Heirs” a person who is legally entitled to the property of another upon the other's death. “Forbearance”
as chattels, household chattels, livestock, Log book or other assets.
the act of refraining from exercising a legal right or enforcing a legal obligation.
“Valid Government-issued Identification” Official documents such as a passport or national 23. The loan must be used for the purpose stated in the loan application form.
identification card that prove a person’s identity and citizenship. 24. The loan amount must not exceed the maximum loan amount set forth by FCL.
‘’Services Outlined in the Loan Agreement” The specific services and obligations that will be provided 25. The loan must be repaid in daily/weekly/monthly installments as per loan FCL schedule
and fulfilled according to the loan agreement. agreement.
“Fortune's Policies, Procedures and GTC ” Fortune’s general terms and conditions of service, 26. The FCL reserves the right to reject any loan application without giving any reason.In the
as well as any relevant policies and procedures related to its services. event of default, the borrower agrees to immediately pay FCL the outstanding balance of
“Group Loan Terms and Conditions” The terms and conditions that apply to the group loan the Loan amount, plus any service charge/penalties due incurred by FCL while enforcement
agreement, including all interests and fees on loans. the loan agreements. I hereby give FCL the absolute legal right to take action.
“Unauthorized Transactions” Transactions that are not approved by the account holder. “Accurate 27. The borrower agrees to abide by all policies, rules and regulations prescribed by the FCL.
Records” Records that accurately reflect all transactions made using the account. “Responsible for 28. The borrower must give advance notice and receive advance consent from the
Debts and Disputes” All members are responsible for any debts or disputes incurred by any of the Association/Group and FCL for any changes in business location, liquidation of major
other members. business assets, or other substantial changes affecting the loan's purpose.
“Absolute legal right” is a legal term that refers to an unqualified, unrestricted ownership of a 29. The undersigned borrower hereby assigns and transfers all right, title, and interest in the
property or a privilege. items of property listed in the property schedule, to FCL, in order to guarantee and secure
“Access to Member Statements” The undersigned has the right to access to each member statement. repayment of the principal sum loaned, service charges, and penalties by the borrower and
“Prompt Notification” Notifying FCL of any changes concerning the members of the group. “Respond any other member of the association/ group.
to Inquiries” All members must agree to respond to inquiries from FCL regarding the loan. 30. In an Event of Default, the undersigned borrower agrees to be personally liable for all
“Liquidation” The process of selling off assets in order to pay off debts or creditors. “Undersigned
payments due and owing to FCL from any member of the Association/Group named above,
Borrower” The party who is borrowing money and signing the agreement. “Guarantee” A
and to be jointly and severally liable for any obligations to FCL or of any member of the
promise or assurance given by the guarantor to another that certain conditions will be met.
Association/Group.
“Asset” Anything owned by a borrower or business that has commercial or exchange value.
UNDER TERMS AND CONDITIONS 31. In the Event of Default, FCL or its agent, or the agent of the Association/ Group, may take
1. All group loan forms applications must be opened with valid government -issued possession and sell/dispose of the assets without consent or notice to the borrower which
identification, such as a valid passport, or valid national identification card and may be done either through private sell or public auction.
other documents as may be required by FCL and also, all members must be over 32. FCL shall stand legitimately possess of the proceeds of any such of the assets and shall,
the age of 18. after paying the costs of such taking possession and sale, apply the same to any amounts
2. FCL will provide the services outlined in the loan agreement. then owing to FCL, if any such excess exists, the funds to be send to the borrower.
3. All group borrowers must agree to abide by the Fortune’s policies, procedures and GTC. 33. The undersigned borrower further agrees that, in the event of borrower’s death, this
4. All group members agree to abide by the group loan terms and conditions of this agreement shall be binding on borrowers’ heirs, executor(s) administrator(s) and personal
group, including all interests, fees on loans. representative; and that any forbearance, indulgence or relaxation by FCL shown or granted
5. The undersigned agrees to be responsible for any unauthorized transactions made to the undersigned borrower in enforcing any terms or conditions of this Agreement shall
using the account and to promptly report any such transactions to FCL. not in any way affect, diminish, restrict, waive or prejudice the rights or powers or FCL under
6. The undersigned agrees to keep accurate records of all transactions made using the this agreement; and that for the duration of the loan or loans to the undersigned borrower or
group account and also records for all members including loan repayment. to any other member of the Association/ Group named above, the undersigned borrower
7. All members must agree to the statement that each member will be responsible for shall not offer the assets as collateral security, for any other loan pledge or any other facilities
any debts or disputes incurred by any of the other members. of a commercial nature. Any deviation from this provision shall be treated as a breach or
8. All members must agree to that the undersigned had a right to access to each contract on borrower’s part and shall entitle FCL or the Association/ Group named above to
member statement. seize the assets without any notice; and that for the duration of the loan or loans to the
9. All members must agree to provide prompt notification of any changes concerning undersigned borrower or to any other member of the Special group named above, the
them. borrower shall not sell or dispose of the assets or otherwise transfer title to the assets to a
10. All members must agree to respond to any inquiries from FCL regarding the loan. third party or trade the assets for property other than that described in the assets schedule
11. All members must agree to the terms of the account and be aware of their individual without the prior written consent of FCL and the Association/ Group named above.
liability. 34. No member of the Group Loan Account shall be allowed to use the loan facility provided
12. Each and every group member is responsible for any action taken by one of the by the FCL for any illegal or unauthorized purpose.
members or representatives of the group. Everyone is equally accountable for any 35. The loan facility provided by FCL shall be used only by the members of the Group and not
transactions made. by any other person or entity.
13. The group members must agree to provide proper notice to FCL of any changes in 36. I certify I read/understood G agree to the Loan Agreement's terms.
the group's membership, group’s address, contact information and any changes of 37. FCL safeguards your personal information through physical, technical, and administrative
officials. measures to prevent unauthorized access, use, disclosure, or destruction. Our security
14. All members of the group must agree to the Fortune's privacy policy. practices are regularly reviewed for effectiveness in accordance with FCL's personal data
15. All members of the group must agree to Fortune's AML and counter-terrorism
financing policies.

CUSTOMER DECLARATION ACCEPTANCE

I confirm that the information given is correct and true to the best of my knowledge. By signing this
application form, I understand that I will be deemed to and confirm that, prior to signing this application form.
I have read, understood and accepted the General Terms and Conditions that apply to Fortune Credit’s
products and services and I hereby agree to comply, observe and be bound by the GTC
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Signature: Date:
Name:

In Presence of: Signature: Date:

FOR OFFICIAL ONLY

VERIFICATION AND APPROVAL AT BRANCH LEVEL

Credit Officer stamp / comments

Name: Signature: Date:

REQUIRED DOCUMENT CHECKLIST

❖ Original ID/ Passport sighted ❖ ID/ Passport copies
obtained Guarantor’s ID
❖ Application form completed
copy
❖ Previous loan cleared ❖ KRA certificate copy obtained
❖ Recent colored passport photo obtained
❖ Business License copy

BRANCH OFFICE LOAN COMMITTEE

STATUS TICK REMARKS AMOUNT TERM

Approved

Pending

Rejected

BRANCH OFFICE COMMITTEE MEMBERS

Name: Signature: Date:

Name: Signature: Date:
Name: Signature: Date:

HEAD OFFICE LOAN COMMITTEE

STATUS TICK REMARKS AMOUNT TERM

Approved

Pending

Rejected
Name: Signature: Date:

HEAD OFFICE COMMITTEE MEMBERS

Name: Signature: Date:
Name: Signature: Date:
Name: Signature: Date:
Name: Signature: Date:
Head office general comments if any: