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Type of Membership
Corporate Membership
Chama Membership
Applicant Details
Add Up to 5 Applicants
Designation:
Full Name as per ID:
ID/Passport No.:
KRA PIN:
Date of Birth:
Nationality
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Panama
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Virgin Islands, U.S.
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Phone Number:
Postal Address/Code:
Occupation:
Email Address:
Place of Residence (Estate, Town, Street, Nearest Landmark):
Next of Kin:
Relationship:
Phone Number:
Name of Business/Company/Group (As Per Registration Certificate):
*
Membership Name for Unregistered Chama (First Name of Signatories - Maximum 4)
*
Nature of Business:
*
Certificate of Registration / Incorporation Number:
*
Date of Business/Company/Chama Registration:
*
Postal Address (P.O Box)
Postal Address/Code:
*
Office Tel No.:
*
Mobile Number:
Email Address
*
KRA PIN:
*
Signature authority or the Account Mandate: (select as appropriate)
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Either to sign
All of us Jointly
Any two sign
Other (Please Specify):
Signatory Details:
Names in full
National ID/ Passport No.:
Signature Specimen (Please upload):
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Registration Certificate Copy:
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PIN Certificate of Company:
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Memorandum and Articles of Association / CR12:
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Group Registration Certificate:
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Copy of ID / Passport Obtained:
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Group Minutes:
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Copy of Directors PIN:
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Step into a brighter financial future
Zuhura Place, Kenyatta Highway, Off Garissa Rd
P.O Box 2049-01000, Thika
fanusi@fanusi.sacco.com
+254 722 363851
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