APPROVAL DATE: __________________
AMOUNT REQUESTED ___________________

AMOUNT APPROVED ______________________
INTEREST RATE: ________________________

PAYMENT TERMS: _____________________
No. OF PAYMENTS: ______________________

DISBURSEMENT INFORMATION

DATE:____________________

BANK DISBURSEMENT:______________________________
ACCOUNT No. _________________

BANK TO CREDIT TO: ________________________________
ACCOUNT No. __________________

LOAN DISBURSEMENT: _______________________

INTEREST AMOUNT FOR LOAN: ________________________

NET FOR DISBURSEMENT: ________________________

CREDITS:

CYCLE AMOUNT No. OF MEMBERS

CYCLE _______________ ___________ _____________________
PREVIOUS

CYCLE _______________ ___________ _____________________
ACTUAL

INCREMENT: ___________ NEW MEMBERS: __________

WITHDRAWN MEMBERS: __________

POSITION DATE SIGNATURE

CREDIT OFICIAL _________________________ _____________________

ADMINISTRATOR ________________________ _____________________

FINANCE ANALIST _______________________ _____________________

PROGRAM MANAGER _____________________ ____________________