Step 1 of 5

Personal & Contact Information

Fields marked with * are required.

Branch / Satellite *

Date *

Member Name *

SACCO Number *

Employment Number *

Date of Birth *

Gender *

Male Female

Marital Status *

Phone Number (s) *

Nationality *

ID Type *

ID Number *

Expiry Date *

Email Address / Fax *

Step 2 of 5

Employment Information

Provide your employer and income details.

Employers Name / Work Station *

Employer Address *

Employment Start Date *

Monthly Income *

Occupation Details *

Tell/Cell Phone *

Step 3 of 5

Residential & Village Details

Provide your residential address and home village.

Residential Address

Area *

Nearby Feature *

House Number

Home Village

Village *

T/A *

District *

Step 4 of 5

Next of Kin & Utilities

Provide family details, utility accounts, and signatures.

NEXT OF KIN

The first Next of Kin is mandatory. Additional Next of Kin are optional.

Next of Kin #1

Name *

Relationship *

Occupation *

Gender *

Male

Female

Phone Number *

UTILITY BILL ACCOUNT

ESCOM

WATER BOARD

Utility bill evidence * Upload bill document *

NATIONAL ID

Upload national ID *

Upload national ID back *

Take a photo holding your National ID *

MAP SKETCH & SIGNATURE SPECIMEN

Map Sketch *

cloud_upload Upload map sketch *

Signature Specimen

cloud_upload Upload signature *

Step 5 of 5

Review & Submit

Please review all your information before submitting. Click back to make edits if needed.

Final Confirmation I confirm that the information provided above is true and correct and authorize UCSSACCO to update my KYC records.

UCSSACCO

KYC Update Form