Credit Application

Please Select The Company*

File

Drop files here or

Accepted file types: pdf, Max. file size: 100 MB.

Please Select One*

Security Provided

Type*

Value (in Kshs)*

Valid till*

Total Credit Limit*

Credit Period Required*

Business Information

Your Full Name*

Prefix First Last

Your Valid E-mail Address*

Business Form*

Business / Company Registration Number*

Memorandum and Articles of Association*

Drop files here or

Accepted file types: pdf, jpg, Max. file size: 100 MB.

Certificate of Incorporation/ Registration*

Drop files here or

Accepted file types: pdf, Max. file size: 100 MB.

Certificate of Incorporation/ Registration*

Drop files here or

Accepted file types: pdf, Max. file size: 100 MB.

Date of Commencement of Business*

Period at Present Location*

Please specify the number of years and months

Business PIN Number*

Upload A Copy of Your Business PIN*

Drop files here or

Accepted file types: pdf, Max. file size: 100 MB.

Whether Exempt from VAT*

Exemption Certificate*

Drop files here or

Accepted file types: pdf, Max. file size: 100 MB.

Annual Turnover for last three years (for the period ended on)

Kshs

Period Ended on

Kshs

Period Ended on

Kshs

Period Ended on

Copy of Audited Financial statements (last 3 years) attached*

Drop files here or

Max. file size: 100 MB.

Business Contacts

Postal Area and Address Code*

Plot number*

Road*

Building / Area*

City / County*

Landline / Telephone*

Mobile Number*

Email Address*

You shall receive your statements on this address

Will Provide Purchse Order (PO) for Purchases?*

Signature Specimen

How many signatories would you like to include?*

Number of signatories

Name*

Prefix First Last

You can print, sign and scan the form after you have filled in the required data

Name

Prefix First Last

You can print, sign and scan the form after you have filled in the required data

Name

Prefix First Last

You can print, sign and scan the form after you have filled in the required data

Name

Prefix First Last

You can print, sign and scan the form after you have filled in the required data

Contact Person

CEO

Name*

Telephone / Extension / Mobile no.*

Designation*

Email Address*

PURCHASES

Name*

Telephone / Extension / Mobile no.*

Designation*

Email Address*

Name*

Telephone / Extension / Mobile no.*

Designation*

Email Address*

DETAILS OF DIRECTORS / PARTNERS / PROPRIETORS / TRUSTEES

Name*

Nationality*

Designation*

Share / Equity (%)*

How Many Other Directors / Business Associates Would You Like to Add?*

Name*

Nationality*

Designation*

Share / Equity (%)*

Name*

Nationality*

Designation*

Share / Equity (%)*

Name*

Nationality*

Designation*

Share / Equity (%)*

BUSINESS ASSOCIATES [Subsidiary / Associated / Holding Company of the customer]

Name*

Relationship*

Address*

Telephone*

How Many Other Business Associates Would You Like to Add?*

Name*

Relationship*

Address*

Telephone*

Name*

Relationship*

Address*

Telephone*

Business Bankers (Two main operating Bankers)

Bank Name*

Branch*

Telephone Number*

Account Number / Type*

Bank Name*

Branch*

Telephone Number*

Account Number / Type*

Trade References (Two Major Trade Suppliers with at least Three years payment record)

Company Name*

Contact Person*

Physical Address*

Mobile Number*

Period of Relationship Since*

Email Address*

Credit Limit / Credit Period*

Please provide details in Kshs and the credit limit period

Company Name*

Contact Person*

Physical Address*

Mobile Number*

Period of Relationship Since*

Email Address*

Credit Limit / Credit Period*

Please provide details in Kshs and the credit limit period

I/ We have read and fully understood Doshi’s Terms, conditions and stipulations governing the credit facilities herein laid out as also in the annexed ‘Credit Facilities Terms & Conditions (as updated by ‘Doshi’ from time to time) and agree to abide by them. I/ We give consent to ‘Doshi Group Company’ to apply to my/our Bankers and / or Trade Referees/ Credit rating agency & to share any information necessary to assess our business/ credit/ financial position and to extend credit facilities. All the information given in this form is true and complete and we do undertake to inform ‘Doshi Group Company’ of any changes in it that may take place in future. I/ We agree to indemnify Doshi/ their agents from any liability resulting from credit review. I/we are fully authorized to make / sign this application in the capacity as below. For and on behalf of the Applicant:

How many Signatories would you like to add?*

Name*

Prefix First Last

Designation*

National ID*

Attach Your National ID Copy*

Drop files here or

Max. file size: 100 MB.

Name

Prefix First Last

Designation

National ID

Attach Your National ID Copy

Drop files here or

Max. file size: 100 MB.

Name

Prefix First Last

Designation

National ID

Attach Your National ID Copy

Drop files here or

Max. file size: 100 MB.

Name

Prefix First Last

Designation

National ID

Attach Your National ID Copy

Drop files here or

Max. file size: 100 MB.

Declaration Form

Download the declaration form, sign, scan, stamp and upload it again on the “Attach Scanned Copy of This Form” below

DOWNLOAD DECLARATION FORM

Attach Scanned Copy of This Form*

Drop files here or

Max. file size: 100 MB.

After filling this form, please print it, sign, stamp, scan and attach it here.

Phone

This field is for validation purposes and should be left unchanged.

Cart

Cart

Credit Facility

Security Provided

Business Information

Annual Turnover for last three years (for the period ended on)

Business Contacts

Signature Specimen

Contact Person

CEO

PURCHASES

DETAILS OF DIRECTORS / PARTNERS / PROPRIETORS / TRUSTEES

BUSINESS ASSOCIATES [Subsidiary / Associated / Holding Company of the customer]

Business Bankers (Two main operating Bankers)

Trade References (Two Major Trade Suppliers with at least Three years payment record)

Declaration Form

DOWNLOAD DECLARATION FORM