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STRIDE DEVELOPMENT CO-OPERATIVE
SAVINGS AND CREDIT SOCIETY LTD
REG.NO.10553/RCS
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BRANCH: ______________________     DATE: ___________________

            PRODUCT					SALARY LOAN                BUSINESS LOAN       AGRICULTURE LOAN
	            (Tick as appropriate)	
  Personal Information:	No. of SHARES: ………………
Name: _________________________ Address: ________________________ ID No. _____________
Account No. _______________________ REFERENCE No. ____________ Mobile No. _______________
Date of Birth: ____________________ Gender/Sex: _________________ Home Location: ____________
Village/Estate/Town: _______________________ Nearest Landmark: ____________________________
Next of Kin: _____________________________ Relationship: _______________ Tel ________________
Marital status: __________________ No. of Dependants: ________________ Ages: ___ ___ ___ ___ ___
Work place Information:  Work Place: __________ __________________ ________
           Location of work place: ______________________ Nearest Landmark: __________________ Employment No: ___________
           Occupation: ________________________ Employment type/ sector: ___________________ Years employed: ____________ 
           Loan Amount Requested: _______________Period ________ Purpose of the Loan: __________________________                    

          How much can you easily pay per week/ month (tick appropriate)                                                                                                                
           Are you able to pay the Loan on Weekly / monthly Basis? (Tick as appropriate) Wkly       Mthly     Specify _____________________
LOAN SECCURITY:                                                                                                                                                                        
 LOCATION:                                                                                           OMV:                                             FSV:                          
          Business Activity: (For business loan only)	
1.	 What is the value of your business?	
	
Item	Amount (UGX)	
Cash and Bank Balances		
Stock		
Business Debtors		
Fixed Assets (furniture, tools, machinery etc.)		
TOTAL		

2.  How much does your business owe to others?		

3.	  Sales:
 Average Daily Sales: _______ X ____ No. of Days sold per week = UGX __________/Week X 4 = UGX ______/Month.  

4.	Other sources of Income:
Source 	
Monthly Average Income (UGX)	

Salary	

Farm/Secondary business	

Other 	

TOTAL	

	

5.	Other Expenses:( all loans)
Expense	
Monthly Average Expense (UGX)	

Purchase of stock	

Transport	

Rent/Market charges	

Salary – self drawings	

Salary – full time employees	

Other business expenses	

TOTAL	

Member’s/ client’s name…………………..………………………………………………. Signature ……………………….

Officer’s recommendations:        AMOUNT……………..……………  PERIOD……………… PRODUCT………….…… Previous Installment………………… Current Installment………………….
………………………………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………………..
…………………………………………………………………… Initials ………………………….. sign ………………………

6.	Comments by the Committee Officials:
Amount approved ………………………. Loan product ………………………………………….. Period ……………………..

	

7.	Comments by the Board Committee :( Above 4m )
Amount approved ………………………. Loan product ………………………………………….. Period ……………………..

	

8.	Guarantor’s Names and Signatures:

    I/ We fully understand our loan repayment responsibilities and STRIDE’s loan repayment rules and regulations.

I/ We the undersigned under take/guarantee the payment of the loan facility advanced to…………. …………………………………………………………… together with interest and penal interest in case of default /inability by the borrower to repay. 

  I/we authorize the recovery of monies in default from my/ our savings account with or without notice.

Guarantor’s Names	
Signature	
Date	
a/c no.	
Telephone	

1.		

	

2.		

	

3.		

	

	

Member’s/ client’s name ……………………………………………………………….. Signature ……………………………

9.	Loan Request Decision:
Committee approval and Conditions
Management committee members
Date:	
Board Committee members
Date:	

Name                                                    Signature	
Name                                                    Signature	

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