MPost Sacco - Membership Form

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Mr. / Ms. Others (Specify)

Gender

Male

Female

Others

Full Name (as per National ID)

ID/Passport No

Date of Birth

Country of Residence

Marital Status

County / Province / City / State

Postal Address / Code:

Primary Mobile Number

Other Number:

KRA

Financial Information

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Occupational Details

Select whether you are Employed or Self-Employed and fill the below form

Employed

Self Employed / Biashara?:

Employer

Employers Address

Gross Monthly Income

Payroll Number

Other Sources Of Income

Select whether you are Employed or Self-Employed and fill the below form

Other sources of income

Pension Income

Yes

Remittances

Select whether you are Employed or Self-Employed and fill the below form

Proposed Monthly Contributions: (Kes.)

Amount in Words

Proposed mode of remittances:

Cheque

M-Pesa

Direct Debit

Others(Please Specify)

NOMINEE / NEXT OF KIN DETAILS

I the undersigned, upon my demise whilst a member of the Society, hereby instruct the Society to pay all amounts due to me less any debts to the Society, to the person (s) named in this section. I understand that I may alter the name of nominated next of kin by filling a subsequent nominee card

Names

NATIONAL ID / PASSPORT NO.

Date of Birth

Relationship

Telephone Number

Please provide a guardian if the nominee (s) is / are below 18years

Relationship

NATIONAL ID / PASSPORT NO.

Mobile Number

SPECIMEN SIGNATURE AND DECLARATION

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declare that all the particulars given by me are true. I confirm that I have read the terms and conditions governing the opening, operating and closure of membership and related e-channels of Stima DT Sacco Society Ltd and agree to be bound by them. I further unequivocally consent that my personal data, collected in connection with such terms and conditions , may from time to time be used and disclosed for such lawful purposes and to such persons as may be in accordance with the Stima Sacco’s prevailing Privacy Policy, and the relevant laws, as amended from time to time. For detailed terms and Conditions, visit https://msacco.com/download/data-privacy-policy/

Full Names

Date

Membership Application Form

Applicant’s BIO-DATA

Financial Information

Occupational Details

Other Sources Of Income

Remittances

NOMINEE / NEXT OF KIN DETAILS

Please provide a guardian if the nominee (s) is / are below 18years

SPECIMEN SIGNATURE AND DECLARATION

How did you hear about MPost Sacco?