Declaration

I (we) declare that the information on this form to the best of my (our) knowledge and belief is true, correct and complete.

In signing this document I (we) agree:

1. To participate in any evaluation study conducted by the SLB for the purpose of assessing the performance of the Financial Assistance programme;
2. To use the monies obtained for the intended purposes only;
3. To allow the SLB, in the event that I default on my obligation to repay all debts (including interest, insurance and charges), to publish or disclose my name and or picture in the print or electronic media, refer my account to a debt Collector, take legal action,, and to take any other measures for the recovery of the debt, as they deem necessary;
4. To allow  the SLB to verify the information provided in this application form;
5. To give the SLB my irrevocable authority to instruct my present and future employers to deduct the amount necessary to settle the outstanding sum due to the SLB in respect of my loan from the salary and any other sums due to me from my said employers and to apply the said sum received from my employer to liquidate any amount outstanding on my loan to SLB in the sole discretion of the SLB.
6. To pay the insurance premium associated with my loan.
7. That I recognize that this declaration supersedes all other declarations signed by me before in connection with my loans at the SLB and that by affixing my signature  hereto I am accepting  all the terms and conditions  outlined in the Master Agreement of which this declaration forms a part .
8. That any modification and or attempted modification of the Master Agreement in any form or manner will result in immediate discard of my loan application, demand  for any sums disbursed to my benefit and disqualification  from any further consideration for a loan from the SLB.

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Signature of Applicant                                                                                 Date

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Signature of Witness                                                                                    Date

Students’ Loan Bureau Representative Only

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Signature of Parent/Guardian                                                                       Date

 if applicant is under eighteen (18)

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Signature of Witness                                                                                     Date

Students’ Loan Bureau Representative

or Justice of the Peace Only