lapf/lon.2
education loan application form
a: Applicant's details
1. Full name……………………… ………………………………………………………………....
2. Gender (male/female)………………………………………………………………………
3. Designation …………………………………………………………………………………..
4. Employer…………………………….………………………………………………………...
5. Check / lapf number………………………………………………………………………...
6. Date of birth……………………………………………………………………………………
7. Date of first employment……………………………………………………………………..
8. Date of confirmation………….........................................................................................
9. Basic salary……………………………………………………..……………………………
10. Do you have other existing loan(s)? (yes) / (no)………….………………………………. A) if yes state total loan deductions from your salary………………………………
b) state the lender (s) ……………………………………………………………….
C) for what purpose e.g. Education, housing etc ………………………………….
D) date issued …………………………………………………………………………...
11. Postal address……………………………………………………………………………….
12. Physical address…………………………………………………………………………….
13. Office telephone………………………….....mobile………………………………………
13. Institution admitted……………………………………………………………………………..
14. Programme admitted ……………………………………………………………………………
15. Duration of the programme admitted…………………………………………………………. B: Lapf loan
1. State the fee amount to be paid to the institution in the 1st year ………………………
2nd year……………………….
3rd year……………………….
4th year……………………….
5th year……………………….
Total loan amount…………………………………
d: Attachments
1. Admission letter from the respective institution.
2. Fee structure/invoice from the respective institution.
3. Permission/release/acceptance letter from the employer
4. Certified copy of recent salary slip.
5. Certified copy of confirmation letter
6. Copy of membership card
e: Declaration by the applicant
i (full name) …………………………………………………….hereby do declare that the information given here in is correct and complete for the fund to consider me for the loan. I also declare that any misrepresentation of information given in this education loan application form lead to disapproval of this loan and may lead to legal action against me.
…………………………………………. ……………………. Applicant's signature
date…………………………………………………………..
F: Employer`s certification and guarantee
i (full name)………………………………………..certify that the particulars of the employee
as recorded above are correct.
And
do here by consent to allow (full name)……………………………………………...to be
considered for education loan to pursue his/ her studies at (university/college)………………
………………………………….. And guarantee his/her recovery of the applied loan throughout the period, i also declare that the maximum deductable amount of applicant is tsh……………………………………………… will be maintained throughout the loan recovery period.
Name……………………………………………………………… designation……………………………………………………………………………………... Signature………………………………………………………………………………………… date…………………………………………………………………………………………….....
Employers rubber stamp/seal
note: Certification and guarantee should be done by competent authority
h: For official use only:
Certification by zonal manager
this is to certify that……………………………………………………has submitted education loan form he/she does qualify/ does not qualify for the following reasons…………………………………………………………………………………………………
……………………………………………………………………………...................................... (if qualifies) i forward to head office for further processing
zonal manager's name……………………………………………………………………….... Signature………………………………………………………………………………………… date…………………………………………………………………………………………….....
Office rubber stamp