Individual Member Application Form - Universal Traders Limited

- Step 1 of 6

APPLICANTS DETAILS

Surname *

Other Names

Gender *

Date of Birth *

Marital Status *

Occupation *

CONTACT DETAILS

Postal Address *

Postal Code *

Town/City *

Telephone

Mobile No *

Email *

IDENTIFICATION

ID NO *

Place of Issue *

KRA PIN *

Passport No

Issue Date

Expiry Date

PHYSICAL ADDRESS

Location *

Street/Building/Estate *

House Number

HOME/PERMANENT ADDRESS

P.O Box *

Code *

Town/City *

IF SELF EMPLOYED (To be completed by business applicant)

Business Name

Street/Buiding/Estate

Official Number

Nature of Business

IF EMPLOYED (To be completed by employed applicant)

Name of Employer

Department

Payroll No

Station

Loacation

Emp No

Terms of Employment

Expiry of Contract

NEXT OF KIN/BENEFICIARY

Next of Kin Full Names *

First

Last

Relationship *

Next of Kin Address *

Town *

Code *

Tel No *

PLEASE INDICATE ACCOUNT HELD WITH UTS OR ANY OTHER BANK

Indicate in the following order (Account Number|Bank|Branch)

MONTHLY REMITTANCE

Monthly Remitance Will Be...

NOTE: Monthly remittance should be done through either Direct deposits, Paybill remittance or Standing order to UTS bank account

I HEREBY NOMINATE THE FOLLOWING NOMINEE (S) TO INHERIT MY SHARES OR INTEREST IN THE SAID SOCIETY IN THE FOLLOWING MANNER

Indicate using the following order (Name|Relationship|% of share/interest)

FURTHER I HEREBY APPLY TO OPEN AN ACCOUNT WITH UNIVERSAL TRADERS SACCO SOCIETY LIMITED

1. TYPE OF ACCOUNT (Tick appropriate Box) *

Akiba Savings A/C
Mwethya Savings A/C
Current A/C (Individual)
Toto Savings A/C
Nawiri Savings A/C
Young TurksA/C
Corporate Current A/C
Raffles Savings A/C

Other (Please Specify)

2. Other Services

a) Issue ATM Card? *

b) Issue Cheque Book? *

Mobile Banking *

Cellphone/Phone Number

3. Introduced By

Member Number

ID No

Tel

Passport Photo *

Click or drag a file to this area to upload.

Allowed File Types (.pdf, .png, .jpg, .jpeg)
File Max Size 7mb.

Signature Upload *

Click or drag a file to this area to upload.

Allowed File Types (.pdf, .png, .jpg, .jpeg)
File Max Size 7mb.

ID Upload *

Click or drag a file to this area to upload.

Allowed File Types (.pdf, .png, .jpg, .jpeg)
File Max Size 7mb.

I confirm that the information provided herein and disclosures made are true and that I agree to abide by the general terms and conditions of Universal Travders Sacco and undertake to comply, observe and be bound by them. I agree that this account shall be aoperated solely at the discretion of the bank and hereby agree to the bank at my cost against any loss/claims arising out of the account being closed by the bank without notice due to unsatisfactory perfomance. *

I AGREE & CONFIRM

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