Mortgage Application Form

SECTION 1: PERSONAL DETAIL /MAELEZO BINAFSI –APPLICANT/MTEJA

Personal Detail/ Maelezo binafsi

Title: MR/Bw. MRS/ Bibi Miss/ Bi MS Other

First name/Jina La kwanza Middle name/ Jina la Kati

Surname/ JinaUkoo

Sex/Jinsia: Male/ Mme: Female/mke:

Marital Status/ Hali ya Ndoa : Single /Sijaolewa sijaoa: Married /Nimeoa/ Nimeolewa: Divorce/Nimechika:

Separate/ Kutengana: Widowed /Mjane:

Date of birth/Tarehe ya kuzaliwa: D D M M Y Y Y Y Nationality /utaifa:

Expiring date/
D D M M Y Y Y Y
No ya Kitambulisho: Muda wa kumalizia:

Date of issue / Tarehe iliyotolewa: Expiring date /Muda wa kumaliza: D D M M Y Y Y Y

Borrower’s Adresss /Anuwani Ya mkopaji

P.o. Box /S.L.P:

Telephone/ Simu Work/ Kazini:

Mobile/ Simu ya Mkononi Email address / Barua pepe:

Present residential Address / Anuani ya makazi

Plot / Block Area /Eneo:

Street / Barabara: House no /Namba ya nyumba:

Rented / ya kupanga: Owned /Binafsi: Others/

Spouses Detail /Habari ya mke

Name /Jina

Employed/ Ameajiriwa Yes/Ndio Hapana/ No

If yes provide employer detail/ Kama ndio , toa maelezo hapa chini

Employer /mwajiri: Designation / cheo:

ID no / Kitambulisho no:

P. O. Box /SLP :

Telephone /simu : Work / kazi: Home/nyumbani

Mobile /simu ya mkononi: Email address / Barua pepe:

Referee/Next of keen/Ndugu wa karibu

NMB account if any/ NMB Account kama ipo:

Name /Jina:

Employer /Mwajiri:

Telephone/Simu: Mobile number/ Simu ya Mkononi:

Relationship of next of kin/mahausiano na mkopaji:

SECTION 2: EMPLOYER DETAILS /TAARIFA ZA AJIRA

Employer’s Name/ Jina la Mwajiri:

P. O. Box /SLP:

Telephone No (work)/Simu ya Kazini:

Status of employment ( please tick Appropriate )/Hali ya Ajira (tafadhali weka tiki panapohusika
Permanent /Ajira ya kudumu: Temporary /Ajira ya Muda: Contract/ Mkataba :

Employee ID /kitambulisho cha Kazi:

Year/ Month in present Job / Miaka /Miezi katika Kazi ya sasa:

Department /Idara: Designation /cheo:

If contractual/ probation / temporary / kama Mkataba /kutazamiwa /ya muda

Commence Date/ tarehe ya Kuanza D D M M Y Y Y Y Expiry Date / Tarehe ya Kumaliza: D D M M Y Y Y Y

For business owner / kwa MfanyaBiashara :

Name of company/ Jina la kampuni :

Nature of business /Aina ya biashara :

Registration number / number ya kampuni :

Physical Adress/ Anwani ya mahali :

Telephone Number /

Number of year in operation/ muda ambapo kampuni imefanya kazi:

SECTION 3: APPLICATION BANKING DETAIL / TAARIFA ZA BENKI KUHUSU MWOMBAJI

Do you have account with NMB ? /Je unaakaunt benki ya NMB yes/ ndio: No/ hapana
If yes / kama ndio

Account / Taja namba ya akaunti no:

Time since you open an account with us (NMB) / Muda tangu ulipofungua akaunt:

Does your salary paid through NMB account / je mshahara unapita akaunt NMB :

Yes/Ndio: No/Hapana:

Do you have any loan with NMB /je una Mkopo wowote na benki ya NMB: Yes/Ndio: No/Hapana:

Outstanding balance / Lender / Monthly repayment / Expering Date/

kiasi cha mkopo uliobaki Mkopeshaji Malipo ya mwezi Tarehe ya Kumaliza Mkopo

SECTION 4: TYPE OF MORTGAGE LOAN/AINA YA MKOPO

Purchase/ Kununua: Equity release: Semi furnish/ kumalizia: Construction/ Ujenzi:

Loan Amount /kiasi Kilichoombwa:

Amount deposited/ kiasi ambacho kilichotangulizwa:

Loan Period/ Muda wa Marejesho:

SECTION 5: SOURCE OF INCOME / VYANZO VYA KIPATO

Monthly gross Salary/Mshahara kwa Mwezi:

Monthly Net salary /Mshahara Halisi:

Another source of income/Chanzo:

For non-Salaried (month Income )/kwa wasiolipwa Mshahara (mapato yao kwa Mwezi ):

Another Source of Income/Chanzo kingine cha kipato TZS /USD:

SECTION 6: MORTGAGE DETAIL / TAARIFA ZA NYUMBA AMBAYO NI DHAMANA

Location property to be mortgage/ Mahali ilipo nyumba inayochukuliwa mkopo;

Block Plot /Ploti: Street road/Barabara:

CT no/hati ya no:

Duration of lease / muda wa kukodi: Date of Issue/ Mda iliyotolewa: D D M M Y Y Y Y

Expiring/Mda inayokwisha: D D M M Y Y Y Y

Name of Seller and contact details/ Jina la muuzaji na taarifa zake:

SECTION 7: MORTGAGE LOAN COMPREHENSIVE INSURANCE

Life Insurance / Bima ya Maisha

I / Mimi…………………………………………………………………………………………………………………………………………
As life insurance is mandatory for this mortgage loan, I hereby authorize NMB bank to arrange life cover to settle the outstanding
principle balance on my mortgage loan account in the event of death, permanent disability,Critical Ilness,and retrenchment .
I authorized NMB to debit my account with life Insurance premium annually. I understand that any granted cover will be subject
to the provision of the details Insurance policy / Kwakua bima ya maisha ni lazima kukatwa kwa huu mkopo wa nyumba, naridhia
benki ya NMB kutayarisha bima ya maisha kwa mkopo wa nyumba. Bima hiyo itatumika kulipia bakaa ya mkopo wangu wa nyumba
endapo tu itatokea kifo, ulemavu wa kudumu, maradhi sugu na kupunguzwa kazini. Nawaruhusu benki ya NMB kukata malipo ya bima
ya maisha kwa kila mwaka. Ninafahamu ya kwamba kila mkataba wa bima ya awali utakuwa sawa sawa na vifungu vyote katika
mkataba mkuu wa bima hiyo ya maisha.

1. Insured Name / Jina la Mchukua Bima …………………………………………………………………………………………

2. Premium amount charge (%) / Kiasi cha Malipo Kitachotozwa %…………………………………………………………….

3. Term loan / Kiasi cha Mkopo……………………………………………………………………………………………………

As Property Insurance is Mandatory; / Kwa kuwa Bima ya Nyumba ni Lazima

1. The bank will arrange suitable short term insurance to protect their insurable interest in the property / Benki ya NMB itatayarisha
bima sahihi kwa kila mwaka kwa ajili ya kulinda nyumba iliyochukuliwa mkopo.
2. The premium is based on the Insurable amount / value financed of the property (the repair or replacement cost) /
Malipo ya bima yatakatwa kwa kuangalia dhamani ya mkopo na thamani ya dhamana (nyumba)

3. NMB BANK will debit My account with the premium on yearly basis / Benki ya NMB itakata malipo ya bima kupitia akaunti yako,
malipo haya yatafanyika kila mwaka.

4. Further insurance premium will be added to principal debt if they are not paid / Malipo ya bima yataongezwa kwenye bakaa ya
mkopo wako endapo hutalipa kwa wakati.

Property insurance value / Thamani ya bima ya nyumba ……………………………..

I hereby undertake to cede a suitable policy to NMB for all the Loan period should I be unable to do so NMB Bank may arrange
appropriate cover on my/ our behalf / Naridhia kukabidhi nakala ya mkataba wangu wa bima ya nyumba kwa benki ya NMB kwa muda
wote wa mkopo na endapo nitashindwa kufanya hivyo naridhia benki ya NMB kutayarisha bima kwa niaba yangu.

Signature / Saini …………………………………………….

Declaration
i) I certify that this information is true and correct and authorize NMB to contact any source for confirmation. I agree to be bound by
the terms and conditions of this facility. I understand NMB reserves the right to decline this application without giving reasons. /
Nathibitisha yakwamba maelezo haya ni ya kweli na sahihi na nina ruhusu benki ya NMB kuwasiliana na chanzo chochote kwa kuhakikisha.
Nakubaliana kujifunga kwa vifungu na masharti ya mkopo huu. Naelewa benki ya NMB ina haki kukataa maombi bila kutoa sababu

ii) I, the Borrower, agree to the following conditions (tick one) Deduct my monthly loan installments and remit the amount so deducted
to NMB for the purpose of making good debt servicing obligations. / Mimi mkopaji, nakubaliana kufwata masharti yote kama yalivyo
oneshwa, kukata marejesho ya mkopo kwa kila mwezi na kuyawasilisha katika benki ya NMB kwa dhumuni la kuwa mkopaji mzuri.

Remit my monthly income to NMB, through my bank account with NMB to enable NMB make recovery of the principal and interest
installments until full recovery of the loan amount. / Nitawasilisha kiasi chote cha mapato yangu kwa NMB kuruhusu rejesho la mkopo kwa
maana ya riba na mkopo mkuu hadi mwisho wa mkopo.
I authorize NMB to deduct the amount of the monthly installment directly from my loan payment account held with NMB / Nawaruhusu
NMB kukata rejesho la kila mwezi mojakwa moja kutoka kwa akaunti yangu ya mkopo ya NMB.

....................................................................................... branch on the / Tawi la ..................................................................Day of each month. / ya kila mwezi

I agree to sign the Bank’s Standard Stop Order Authorization and to be bound by all the terms and conditions thereof. / Nakubali

iii) I do hereby mandate my employer that upon cessation of my employment by resignation, abscondment, dismissal, retrenchment,
termination, or any other separation, to remit to NMB Bank account my terminal benefits for recovery of the balance due. / Nampa
uwezo mwajiri wangu kwamba nitakapoacha ajira ama kwa kustaafu, kutoroka, kufukuzwa, kupunguzwa, kuachishwa au kwa sababu yoyote
kupeleka mafao yangu Benki ya NMB ili kulipia deni lililobakia.

iv) I authorize…………………………………………………. to conduct valuation of my property/properties.

Nawaruhusu ...................................................... Kufanya uthamini wa jengo langu.

v) I authorize……………………………………to prepare bill of quantities for my building construction.

Nawaruhusu.................................................. waniandalie makadirio ya gharama za ujenzi wa jengo langu.

vi) I, the Borrower, agree and authorize NMB, financial institution or TBA approved credit reference bureau to: / Mimi, ninayekopa, nakubali
na kuidhinisha NMB, taasisi ya kifedha au TBA - zenye mamlaka - kufanya yafuatayo:

(a) Make inquiries from any bank, financial institution or TBA approve credit reference bureau in Tanzania to confrim any information
provided by me / Kufanya uchunguzi kutoka katika benki yoyote, taasisi ya kifedha au TBA wenye mamlaka nchini Tanzania kuthibitisha taarifa
zozote nilizozitoa.

b) Seek informarion from any bank, financial institution or TBA approve credit reference bureau when assessing me at any time during
the existence of my accounts / Kutafuta taarifa kutoka katika benki yoyote, taasisi ya kifedha au TBA wenye mamlaka nchini Tanzania wakati
wowote watakapokuwa wananitahmini kuhusu kuwapo kwa akaunti yangu.

(c) Disclose to TBA approved credit reference bureau information relating to the account maintained at NMB. / Kutoa kwa taasisi ya TBA
yenye mamlaka taarifa kuhusiana na akaunti zangu zilizoko NMB.

This Agreement is governed by the laws of the United Republic of Tanzania / Mkataba huu unatawaliwa na sheria za Jamhuri ya Muungano
wa Tanzania

Signed at/ Imesainiwa ................................... On this/ siku........................ .day of/ ya......................... mwaka 20.......

Name/ Jina:.....................................................................................................................................................................

Signature/ Saini: .......................................................................................................................................................

Bank use only/ Kwa Matumizi ya Benki tu

Recommended by/ Imeidhinishwa na:
Loan Officer’s Name / Jina la Afisa Mikopo : ........................................................................................................................................................
Signature/ Saini: .........................................................................................................................................................................................................

Date/ Tarehe:..............................................................................................................................................................

Branch Manager/ Meneja wa Tawi: Approved/Imeidhinishwa Declined/ Imekataliwa

Signature/ Saini: .......................................................................................................