I,

Authorize the Comhigh Board of Management to deduct upfront 5% interest from the amount to be disbursed.

I also understand and fully agree that the advance dividends paid to me shall be settled from my final dividend payout as shall be resolved during the Annual General Meeting (AGM) to be held in 2026

FOR OFFICIAL USE:

CHECKED BY ACCOUNTS ASSISTANT:

Name .................................................................................................
Signature ..........................................................................................
Date ....................................................................................................

Applicant qualifies for KES................................................................
(in words)……………………………………………………………..……………

TREASURER'S RECOMMENDATION:

Name .................................................................................................
Signature ..........................................................................................
Date ....................................................................................................

Recommends the applicant to be paid KES ..........................................
(in words)………………………………………………………………………..……………

CHAIRMAN'S APPROVAL:

Name ...................................................................................................
Signature ............................................................................................
Date ......................................................................................................

I approve the applicant to be paid KES ...................................................
(in words)…………………………………………………………………………..…………


(Less 5% interest) via Cheque No ................................. Dated ...............................

Applicant's Name ............................................ Signature .......................... Date .......................


Comhigh Sacco Advance on Dividends Application form