Ashesi - Employee Loan Request Form

[Pages:2]EMPLOYEE PERSONAL LOAN REQUEST FORM

Employee Information

Request Date:

(dd/mm/yyyy)

Employee's Full Name: Mailing Address: Non-Ashesi Email Address: Primary Contact Tel. No. : Secondary Contact Tel. No.: Emergency Contact Person: Contact Tel. No.

Relationship: or

Job Information

Job Title:

Department:

Job Start Date: Job Status (Please select appropriate answer):

(dd/mm/yyyy)

Please specify, or provide at least the month and year.

Full Time

Part Time

Annual Gross Salary:

Currency: GHC

USD

Loan Information

Purpose For Loan:

Amount Requested:

Full Payment Duration:

12

Loan Interest (%)

0

Monthly/Bi-weekly Pay Deduction:

Final Payment Due Date:

*Note: You are eligible for up to 25% of your annual gross salary

months

monthly or (dd/mm/yyyy)

bi-weekly

EMPLOYEE PERSONAL LOAN REQUEST FORM

Loan Policy

This loan is given to employees of Ashesi University College with the following conditions: 1. They are full time employees of Ashesi University College 2. They have worked for at least nine (9) calendar months at Ashesi University College 3. They agree to monthly deductions from their pay as indicated above 4. They agree to pay the loan in the duration indicated above, or face a penalty 5. The penalty shall be as determined by the Finance Committee or the Executive Committee

I understand and accept the terms of the loan described above.

Signature:

Date Received:

Amount Approved:

Date Approved: Name:

Approved By:

Name: Disbursed By:

Cheque Information:

Bank:

For Office Use Only (dd/mm/yyyy)

(dd/mm/yyyy) Job Title:

Signature:

Job Title:

__________________________ Signature:

__________________________ Cheque Number:

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