WEMA BANK STAFF MULTIPURPOSE COOPERATIVE SOCIETY LIMITED27, Nnamdi Azikiwe Street, Tinubu, Lagos. T. 0908 359 3629, 0905 362 3279E. wemacoop@yahoo.com W. www.wemacooperative.com

LOAN APPLICATION FORM

PERSONAL DETAILS

COMPLETE IN BLOCK LETTER

Surname Other Names

Branch/Department

First Name

Grade

AFFIX RECENTPASSPORT

PHOTOGRAPH HERE

Date

NEXT OF KIN

Name

Residential Address

Relationshp

E-mail Mobile No. 1 Occupation

Amount in Words

Other Loan Obligations

Other Cooperative Loan

Total MonthlyRepayment

Monthly Repayment

TERMS & CONDITIONS FOR LOAN APPLICATION

I. Duly filled Loan Form ii. Duly filled Guarantor Forms iii. Attachment of post-dated cheque by applicant 50% of loan amount

iv. 3-month pay-slip and bank statement v. One passport/photocopy of ID Card. Members may apply to liquidate existing loans to take new loan if he/she has repaidat least 66% of current loan. This is permissable when loan is liquidated in cash or cheque.

ACCEPTANCE OF LOAN TERMS AND CONDITIONS

I, __________________________________________________ hereby unconditionally accept the Societys terms and conditions governing the requested loan

Applicant’s Signature & Date

d d m m y y y y

Please turn over leaf- 1 -

Residential Address

Mobile No.

Length of Stay (months)Date of Joining Corp. d d m m y y y y//E-mail

Desired Monthly Savings

Mid-month Salary

N

N AC No. Month-end Salary N

Note: Minimum acceptable monthly savings for Wema Bank Staff and RCO/Contract Inspectors - N5,000.00 and Whytecleon Staff - N2,500.00

FACILITY DETAILS

RequestedAmount N Requested

Tenor

Name & Signature Head, Retail Loan

N

N

N

Retail Loan N

I.

II.

FOR OFFICIAL USE ONLY

Manager Appraisal

President’s Approval

Trustee’s Recommendation

Signature & Date

Signature & Date

FOR COOPERATIVE SECRETARIAT’S RECORD

Approved Amount N Approved Tenor (months) NRepayment

Repayment Start Date d d m m y y y y// d d m m y y y y//End Date

N

Signature & Date

WEMA STAFF COOP

Staff No.

BVN

Year of employment

NEXT OF KIN

Name Relationship

Residential Address

E-mail Mobile No.1 OccupationOccupation

FACILITY DETAILS

Current Savings balance Current loan balance Net balance

FACILITY DETAILS

Current Savings balance Current loan balance Net balance

Requested Amount

RequestedTenor Amount in words

Other loan obligations

I. Other Cooperative Loan NMonthlyRepayment

Desired MonthlySavingsN N

I I. Retail Loan Total MonthlyRepayment A/C No.

TERMS AND CONDITION FOR LOAN APPLICATION

Month end salary

I. Duly filled Loan form ii. Duly filled Guarantor forms iii. Attachment of post-dated cheque by applicant 50% of loan amount. iv. 3-month pay-slip and bank statement v. One passport/photocopy of ID Card. Members may apply to liquidate existing loans to take new loan if he/she hasrepaid at least 66% of current loan. This is permissible when loan is liquidated in cash or cheque.

ACCEPTANCE OF TERMS AND CONDITION: Applicant's Signature and date:

Guarantors

1. Name Staff No. Savings amt. Loan amt. Net amt

2. Name Staff No. Savings amt. Loan amt. Net amt

3. Name Staff No. Savings amt. Loan amt. Net amt

ApplicantApplicant

Savings balance: Loan balance: Net balance:Applicant

Savings balance : Loan balance : Net amount:

E-mail(Unofficial):

Date BVN

Date of membership

E-mail (Alternative)

Date of membership Year of employment

Relationship:

Mobile No.

Current Savings Balance Current Loan Balance Net Balance

RequestedAmount

Requested Tenor: Amount in Words

Other Loan Obligations

Other Cooperative Loans Monthly Repayment

Monthly Savings

Month End Salary Total Monthly Repayment

Min:WEMA - N5,000.00 , Others - N2,500.00)(

i. Duly filled Loan Form. ii. Duly filled Guarantor Forms iii. Attachment of post-dated cheque by Applicant to cover Wemacoop exposure.iv. 3-months pay-slip and bank statement v. One passport/photocopy of staff ID Card. Members may apply to liquidate existing loans to take new loan if he/she has repaidat least 66% of current loan. This is permissible when loan is liquidated in cash or cheque.

Guarantors

1. Name Staff No Savings Amt. Loan Amt. Net Amt.

1. Name Staff No Savings Amt. Loan Amt. Net Amt.

1. Name Staff No Savings Amt. Loan Amt. Net Amt.

1. Name Staff No Savings Amt. Loan Amt. Net Amt.

2.

3.

4.

Savings Balance: Loan Balance: Net Amount:

Guarantors

1. Name Staff No Savings Amt. Loan Amt. Net Amt.

. 2. Name Staff No Savings Amt. Loan Amt. Net Amt.

3. Name Staff No Savings Amt. Loan Amt. Net Amt.

1. Name Staff No Savings Amt. Loan Amt. Net Amt.1. Name Staff No. Savings Amt. Loan Amt. Net Amt.

2. Name Staff No. Savings Amt. Loan Amt. Net Amt.

3. Name Staff No. Savings Amt. Loan Amt. Net Amt.

ACCEPTANCE OF TERMS AND CONDITION: Applicant's Signature an date:

Applicant

ACCEPTANCE OF TERMS AND CONDITION: Applicant's Signature & date

Date

FACILITY DETAILS

Current Savings Balance Current Loan Balance (N) Net Balance (N)

Requested Amount (N) Amount in Words : Requested Tenor(Months)

Other Loan Obligations

i. Other Cooperative Loans (N) Monthly Repayment (N) Outstanding Balance (N)

ii. Retail Loan (N) Monthly Repayment (N) Name & Signature :

iii. Month End Salary (N) Total Monthly Repayment (N) Net Salary (N)

(N)

Head, Retail Loan

1. Name Staff No. Savings Bal. Loan Bal. Net Bal.

2. Name Staff No. Savings Bal. Loan Bal. Net Bal.

3. Name Staff No. Savings Bal. Loan Bal. Net Bal.

Date of Membership

- 2 -