DENNERY COMMUNITY CREDIT CO-OPERATIVE SOCIETY LIMITED

APPLICATION FOR A LOAN UNSECURED BY SHARES-FORM L2

(To be completed by the officer)

Loan No. Code Date Approved Security** Rate of Interest Total Amount($) Balance($) Monthly Repayment($) Period of Repayments Loan Status
1
2
3

*Loan Standing: In Good Standing (A) Refinanced (B) Delinquent (C)

*Security: Shares SV, Character CS, Bill of Sale BS, Mortgage, M, Bill of Charge BC, Other O

SECTION 1 (To be completed by Applicant - delete or tick as appropriate)

(BLOCK LETTERS)        Surname        First Name        Other Name (Alias)


Format: 1758-555-5555

Format: 1758-555-5555

Format: 1758-555-5555

Format: 1758-555-5555
Years

Format: 1758-555-5555

I agree to pay (a), (b), (c) above in fortnightly or monthly installment of $_____________ in addition to $______ for purchase of shares.

Full disclosure of debt or financial commitments

Company/Institution Reason for Debt Date Incurred Amount Balance Monthly Repayment($) Status

Attestation

I hereby declare that I am not indebted to any other credit Union, Bank or Loan Agency either as a maker or Escrow except as stated on that form. I hereby warrant and confirm that the foregoing statements are true and correct and have been made by me knowing that you will place reliance on them when considering my application. You are hereby authorized to check any information you may require relating to this application form any source to which you may apply and each such source hereby authorized to provide you with such information. I undertake to notify the Society immediately of any situation which materially changed the representation made in this application for a loan.

X________________________
Signature of applicant

________________________
Witness - Credit Officer


SECTION II

LOAN AGREEMENT

Date: ______20___

Account No.__________________

Loan No._________

Amount $____________________

Repayment terms $___________per month/fortnight for ________ months/fortnight

For value received, I/we the undersigned, waving my/our rights of demand and notice, jointly and severally promise to pay the Dennery community Credit Co-operative society Limited the sum of $___________________being the present loan balance $___________________ and new application $___________________ with interest on the unpaid balance at the rate of interest of ______percent per annum on the monthly reduction the first payment of $________to be made commencing in the month of _______________and a like amount every _____________thereafter until full amount has been paid.

Upon default of payment of any installment of this note or in the event money borrowed on the note is not used for the purpose set forth in this application or in the case of misrepresentation of misstatement made by the borrower or co-maker in obtaining this loan or in case the holder shall deem the security thereof unsafe for any reason whatsoever, then this note, or so much thereof as may remain unpaid shall at the option of the holder immediately become due and payable. In the event of default the maker hereof pledge any shares owed or hereinafter held by the society as additional security for the payment of the obligation and I/we authorize the Treasurer to apply any or all such shares or payment on shares to payment of this loan, interest, cost expenses, also, if the holder hereof after default shall place this note in the hands of a solicitor(or approved agent or collector) for collection, the undersigned agrees to pay an additional sum as a fee collection equal to thirty percent or such other percentage and of change in fees and approved by the board at the time of referral for collection of the current obligation which was deemed unpaid at the date of referral to the solicitor and/or collector. Such charge for collection in one event is to be less than one hundred dollars. In the event of termination of my services by me or my employer to deduct the unpaid balance of this loan from all or any monies due to me at the time of such termination and if the said amount is not paid, I shall authorize my new employer within or outside St. Lucia to pay the said unpaid balance of this loan to Dennery community Credit co-operative Society Limited whether demanded by the Credit Union or not. In the event of severing duties with another employer within the State of St. Lucia, I shall continue to recognize the conditions of repayments as set out in the loan agreement by notifying my new employer in this particular case, through the management of the Dennery Community Credit Co-operative Society Limited. I agree to repay in full the amount outstanding to the date of my termination.

Signatures

Witness

Maker X___________________________

1______________________

Date: ________________________

Date: _________________

Co-maker/ Guarantor_________________________

2______________________

Date: _____________________

Date: _________________


SECTION III

COMAKERS/GUARANTORS INFORMATION

Signature: _____________________


SECTION IV

Comments of Manager or Credit Officer_______________________________________________________________________________

___________________________________
Signature of Manager or Credit Officer


SECTION V

A. DECISION OF CREDIT COMMITTEE

On___________________20____ we considered this application and decided as follows:

we-

Signed and dated

1. Approved the loan

1.___________________________

2. Approved the loan on conditions

2.___________________________

3. Refer the application to the board

3.___________________________

4. Defer the application

4.___________________________

5. Reject the application

5.___________________________

Amount approved $______________ (in words) ____________________________________________________

Reasons (2) (3) (4) (5) __________________________________________________________________________
_____________________________________________________________________________________________


B. DECISION OF BOARD OF DIRECTORS/JOINT COMMITTEE

On____________20____ we considered this application and agreed to the following.

Signed and dated

1. Approved this application

1.___________________________

2. Approved this applicaiton

2.___________________________

3. Defer this application

3.___________________________

4. Rejected this application

4.___________________________

Amount approved $______________ (in words) ____________________________________________________

Reasons (2) (3) (4) (5) __________________________________________________________________________
_____________________________________________________________________________________________


SECTION V1 FOR EXTERNAL USE ONLY

Disbursement:

Part payment   
Other   
PAYEE VOUCHER DISB NO. DATE CHEQUE NO. Amount $ Balance $
           
           
           
           
           
           
           
           

Payment start date: ___________________________________

Payment approved by: ___________________________________

Date: ___________________________________

DENNERY COMMUNITY CREDIT CO-OPERATIVE SOCIETY LIMITED

MONTHLY BUDGET-DEBT SERVICE RATIO

MUST BE COMPLETED

MONTHLY INCOME

$

$

A

GROSS MONTHLY INCOME

B

OTHER INCOME STATE SOURCE(    )

C

OTHER INCOME STATE SOURCE(    )

TOTAL MONTHLY INCOME (A+B+C)

MONTHLY EXPENDITURE

A

PAYE & NIC

B

INSURANCE

C

CHILD SUPPORT ALIMONY

D

UNION DUTIES. OTHER DUTIES

E

LOAN WITH OTHER INSTITUTIONS

Current Balance

1. CREDIT CARD(S)

2. CREDIT UNION LOAN

3. BANK LOANS

4. FAST CASH

F

Hire Purchase

TOTAL DEBT SERVICE EXPENSES

Available Income After Debt

DEBT SERVICE RATIO

%

LIVING EXPENSES

A

Food

B

Electricity

C

Telephone

D

Water

E

Transportation/Fuel

F

Entertainment

G

Monthly commitment to savings

Total

Total Monthly Expenses

Available Income After Total Expenses

Debt Service Ratio with Living Expenses

%
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