Rural Peri-Urban Housing Loan Application Form

[This form must be completed in full]

A. PARTICULARS OF APPLICANT

Surname:

Other Names:

Age:

Sex:

Male
Female

National ID/Pasport No.:

Marital Status:

If Married, Name of Spouse:

Address:

B. POSTAL AND RESIDENTIAL ADDRESS OF APPLICANT

P.O BOX:

Telephone No.:

House Tel No (Office):

CellPhone:

Email Address:

Place of Residense (Town/City):

Estate:

Plot No:

Are these premises owned by you?:

Are these premises rented by you?:

If rented please state the name of the and address of owner::

Owners Name:

Owners Address:

Owners Tel. No:

C. LOAN APPLICATION

State amount of loan required KSH (Subject to a maximum loan of Kshs. 1,500,000):

Indicate repayment period(yrs)(Subject to maximum repayment of ten years):

State whether employed or in business ::

If employed indicate Name of Employer:

Address of Employer:

Position Held:

Length of Service::

INCOME DETAILS:

Monthly Salary (ksh)::

Monthly House allowance/Owner Occupier (ksh)::

Monthly Wife's/Husband Income (Ksh):

Other Monthly (ksh)::

Other income (ksh)::

Total Monthly Salary:

IMPORTANT:- Please attach a certificate from your employer to confirm the particulars indicate above.

If self employed, state:- Nature of business /occupation[describe briefly]:

Name of Business:

Business Address::

Business Tel. No:

Business Location::

Income Details

Monthly Income (Ksh):

Any Other income (Ksh):

Total monthly Income:

IMPORTANT: Please attach current bank statements and audited accounts to support your income for the last six months

E. LOCATION OF HOUSE BEING FINANCED

Name of Villages/Town:

Sub-location:

Name of Assistant Chief:

Location:

Name of Chief:

Constituency/Division:

District:

Nearest major Town:

CONSTRUCTION STAGE :

Briefly describe the stage of construction-achieved to date:

F. SECURITY FOR LOAN

(i) Give the L.R NO.Of the plot on which the proposed house is being constructed.:

(ii) Give the L.R NO.Of the plot/prorerty to be charged as security for the loan (security for loan should be title deeds/leases for land in urban and peri urban areas only):

(ii) Indicate your own estimate of the open market value of the security in (ii) above.(In Ksh):

(iv) Distance from location of the security to nearest major town (In km):

G. NHC ACCOUNT

Have you held previous accounts with NHC?:

If so, specify and write reference numbers below::

1. Rural housing loan account No.:

2. Tenant Purchasing Account No.:

3. Rental scheme [Name]:

4. House No.:

5.Current/Previous loans with other institutions (Name the institution):

Year advanced:

Others (specify):

I ENCLOSE

(i) Two copies of the plan of proposed house

(ii) A sketch route map showing direction to (i) the site of construction and
(ii) to the property/security to be valued, if the two are different.

(iii) A letter from your employer and resent pay slips or audited financial statements/bank
statements for the last six months as proof of EACH source of income.

(iv) Two photographs of proposed house, where applicable.

(i) Two copies of the plan of proposed house

(vi) Copy of PIN certificate

(vii) Copy of certificate of incorporation/registration of business

(viii) Copy of title/lease to be offered as security for the loan. Attach copy of official search.

(ix) Any other information you deem relevant in support of tour application.

H. DECLARATION

I certify that the information i have given above is true and correct to the best of my knowledge and i shall take full responsiblity for the suppling of the same:

WITNESSED BY :
[Witness must be a local administrator/preferably area Chief]

Name:

Position:

Address:

signature:

Date:

Send me a copy

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Rural Peri-Urban Housing Loan Application Form