KILIFI COUNTY MICROFINANCE FUND (MBEGU FUND)

Group Loan Application

APPLICANTS DETAILS (as appears on ID, passport or certificate of registration(attach copy)

First Name

Middle Name

Last Name

Position

GROUP DATA

Group Name

Date of Registration

Reg.No./SerialNo

Postal Address

Postal Code

Town

Physical Address

Rent

Years

Township/Estate/Village Plot No./Street

Nearest Church/Mosque/Primary School to the business

Official Phone Number

Official Email ID

MEMBERSHIP PROFILE

Gender	Number of Members	Members with Disability
Male
Female
Total

BRIEF BACKGROUND OF THE GROUP

Purpose/Objectives

Attach Constitution

Key Activities

KILIFI COUNTY MICROFINANCE FUND (MBEGU FUND)| Group Enterprise Loan Application Form GROUP BUSINESS ENTERPRISE INFORMATION

Type of Business:

#Manufacture

#Retailer

#Service

#Agriculture

#Wholesale Distributor

Others

Is the Business:

#Startup(New)

#Existing

If existing state number of years in operation

Business performance per annum :

I. Total income Ksh

II. Total expenses Ksh

III. Operating surplus Ksh

Attach Audited Accounts

Attach Financial statement.

GROUP BANK DETAILS

Bank Name:

Bank Branch:

Bank Account No:

GROUP BANK DETAILS

s/n	Lending Bank/Institution	Date loan granted	Amount granted	Repayment Period	Monthly Repayments	Outstanding A mount
1
2.
3.
4.
5.
6.

LOAN REQUEST

Loan applied for:

Loan Purpose :

Months (Maximum 24 months) :

DECLARATION

Declaration

For Officials

We, the undersigned, being the Owners /Directors/ Proprietor of the Firm hereby commit to repay the loan amount disbursed to the Mbegu Fund appointed Account in equal installments after the Month’s grace period.

s/n	Name	Upload ID	ID Number	Mobile Number	Signature	Date
1
2
3

CERTIFICATION

Sub-County:

Ward:

Village:

Name of Ward Administrator:

Telelphone No:

I certify that I know the members of the group and they are of good conduct to access public funds. I therefore recommend them for Mbegu Fund.

Signature Official Stamp (Mandatory) :

Upload Ward Administrator Signed Copy

DOCUMENTS SUBMITTED

Registration certificate

Proposal or business plan

Evidence of group savings structure

Audited account

Loan Agreement

3/6 months bank statement

Proof of Identity

Details of Existing Bank Borrowings

Constitution

Minutes of Meeting

Other Relevant

Human?

We confirm having submitted the following self attested documents (ticked below) along with this loan application form.

#Complete Loan Application

#Registration Certificate

#Proposal Business Plan

#Group Saving Structure

#Audited account or financial statements Loan A

#Loan Agreement

#n3/6 Months bank statement

#Proof Identity

#Details of Existing Bank Borrowings Constitution

#Minutes of Meeting.

Send

KILIFI COUNTY MICROFINANCE (MBEGU) FUND

Kenya

+254 790 465544

kilificountymicrofinancefund@gmail.com