MEMBERS SAVINGS SCHEME WITHDRAWAL FORM

KANISA SAVINGS AND CREDIT

CO-OPERATIVE SOCIETY LTD.

All Africa Conference Churches compound, Opp. Safaricom House, Waiyaki Way. P.O. Box 1210, 00606 Sarit Center, Westlands, Nairobi, Kenya - Tel: 4450135 / 0714-612049 Email: kanisa@aacc- or info@kanisa- - Website: kanisa-

MEMBER SAVINGS SCHEME WITHDRAWAL FORM

(Complete this form in block capital letters)

TO: The Hon. Secretary, Kanisa SACCO Ltd. P. O. Box 1210-00606 Nairobi, Kenya

I ........................................................... Membership No.................. do

hereby make an application to withdraw Kshs................... In Words..............

........................ ...... ...................................... from my Savings.

Member's Signature....................................Date........................... Personal Account Details Full Names: .............................................. ID No ................................. Mobile Phone No...........................E-mail Address: .............................................

Name to appear on Cheque:....................................................................

FOR OFFICIAL USE ONLY

CHECKED BY:

CONFIRMED BY:

Staff Name................................. Name..........................................

Designation ..............................

Designation ....................................

Signature .................................

Signature .......................................

Date ......................................

Date .................................

DISPATCH OF CHEQUE

Cheque No.:..........................KSHS.................................Date....................................

Cheque Collected By: ..............................................................................................

ID NO..........................................SIGN.................................................................

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