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HAZINA SACCO SOCIETY LTD P. O. BOX 59877 00200 NAIROBI. TEL 2722106/2719098. Wireless 020 2428634 Mobile 0712149631/2150238. FAX 2729187/ 020 2428634. Email*info hazinasacco. or. ke REGISTRATION FOR HOLIDAY FUND/ JIPANGE ACCOUNT Preamble The society has introduced a scheme which allows members to save for holidays. Members are allowed to make contributions to the fund for a period of at least six months after which they may withdraw all or part of whatever they will have contributed* Members who wish to join the scheme should fill this form accordingly. I Dr/Mr/Mrs/Miss/Ms Apply to join the Hazina Holiday fund with effect from and herewith find a form for authority for salary deductions. Please indicate the month in which you will come for part or all of your contributions. Signature Date A PERSONAL DETAILS FULL NAMES DESIGNATION MINISTRY/ORGANISATION PERSONAL NUMBERM/NO DATESTATION STATION ADDRESS TELEPHONEEXT MOBILE TELEPHONE NO E-Mail B AUTHORITY FOR SALARY DEDUCTIONS Authorise you to deduct of Kshs. from my monthly salary with effect from the month of 20 SIGNATURE C FOR OFFICIAL USE ONLY CHECKED BYSIGNATURE DATE DUE FOR REFUND. FAX 2729187/ 020 2428634. Email*info hazinasacco. or. ke REGISTRATION FOR HOLIDAY FUND/ JIPANGE ACCOUNT Preamble The society has introduced a scheme which allows members to save for holidays. Members are allowed to make contributions to the fund for a period of at least six months after which they may withdraw all or part of whatever they will have contributed* Members who wish to join the scheme should fill this form accordingly. Members are allowed to make contributions to the fund for a period of at least six months after which they may withdraw all or part of whatever they will have contributed* Members who wish to join the scheme should fill this form accordingly. I Dr/Mr/Mrs/Miss/Ms Apply to join the Hazina Holiday fund with effect from and herewith find a form for authority for salary deductions. I Dr/Mr/Mrs/Miss/Ms Apply to join the Hazina Holiday fund with effect from and herewith find a form for authority for salary deductions. Please indicate the month in which you will come for part or all of your contributions. Signature Date A PERSONAL DETAILS FULL NAMES DESIGNATION MINISTRY/ORGANISATION PERSONAL NUMBERM/NO DATESTATION STATION ADDRESS TELEPHONEEXT MOBILE TELEPHONE NO E-Mail B AUTHORITY FOR SALARY DEDUCTIONS Authorise you to deduct of Kshs. Please indicate the month in which you will come for part or all of your contributions. Signature Date A PERSONAL DETAILS FULL NAMES DESIGNATION MINISTRY/ORGANISATION PERSONAL NUMBERM/NO DATESTATION STATION ADDRESS TELEPHONEEXT MOBILE TELEPHONE NO E-Mail B AUTHORITY FOR SALARY DEDUCTIONS Authorise you to deduct of Kshs. from my monthly salary with effect from the month of 20 SIGNATURE C FOR OFFICIAL USE ONLY CHECKED BYSIGNATURE DATE DUE FOR REFUND. FAX 2729187/ 020 2428634. Email*info hazinasacco. or. ke REGISTRATION FOR HOLIDAY FUND/ JIPANGE ACCOUNT Preamble The society has introduced a scheme which allows members to save for holidays. Members are allowed to make contributions to the fund for a period of at least six months after which they may withdraw all or part of whatever they will have contributed* Members who wish to join the scheme should fill this form accordingly. I Dr/Mr/Mrs/Miss/Ms Apply to join the Hazina Holiday fund with effect from and herewith find a form for authority for salary deductions.

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