LAFARGE CEMENT ZIMBABWE LTD CAR SCHEME

APPENDIX 3

APPLICATION FORM FOR SCHEME CAR

Company Car Scheme:

This application is to be completed in triplicate.

Section A

To: Human Resources and Communications Director

I hereby apply for a loan under the Lafarge Cement Zimbabwe Ltd Leasing Company Scheme to
purchase the following vehicle:

Make: …………….……………………….. Model:…………………………………….

Capacity: ……………..CC Age………………………………………….

Purchase Price : ……ZWL……………………………….

Loan requested : …… ZWL………………………………

I understand that the loan agreement is between myself and the bank. I understand that Lafarge
Cement Zimbabwe Ltd is a facilitator and guarantor of the scheme.

If my application is granted, I agree to abide by the rules of the scheme. I understand that the loan
will be denominated in ZWL and that I shall be liable to repay the loan through monthly installments,
which shall also be denominated in ZWL.

I commit to make payments towards the vehicle loan for as long as any balance remains outstanding
on the loan advanced to me by the bank. I hereby authorise the Lafarge Cement Zimbabwe Ltd to
facilitate repayments to the bank by deducting the loan installments from my monthly salary or any
other monies that may from time to time be due to me from the Company.

I am responsible insuring the vehicle and under no circumstances shall Lafarge Cement Zimbabwe
Ltd be liable for any outstanding loan balances, indirect, incidental or consequential damages
including loss of use of the vehicle.

Conditions to be applied upon the termination of employment

In the event that I am no longer an employee of Lafarge Cement Zimbabwe Ltd, and I fail to make the
necessary arrangements to repay the outstanding debt the amount remaining will be deducted from
my final termination benefits.

With regard to any outstanding balance following such a deduction, I hereby authorise the facilitating
bank to;

1. Take possession of the vehicle for re-sale and recover the outstanding amount. The proceeds
of the sale shall be credited against the amount outstanding. This arrangement will be
between myself and the bank.

2. If the proceeds upon sale of vehicle are not adequate to cover the outstanding loan amount
then I shall ensure that I raise the outstanding amount from my personal finances to repay the
bank. Any breach or failure to pay within a period of time to be specified by the bank, the bank
will enforce loan repayment and I will have the obligation to meet the liability in full.

3. If the employee is engaged by a new employer the employee can enter into an agreement
with the bank and new employer to recover, set off or reorganize the outstanding debt.

12/30/19 Approved by ………………………2nd Approval ………………….…………

Date:…………………………. Applicant:……………………………………..

Signature of applicant:……………………………….

Witness:………………………………………………

Name: ………………………………………

Recommendation:…………………………………………………………………...…….
……………………….................................................................................................
………………………………………………………………………………………….
………………………………………………………………………………………….
Head of Department:……………………… Date:…………………………...

Section B (to be completed by the Human Resources Director)

I have scrutinized the application and checked the conditions of the car scheme and recommend/not
recommend the application for the following reasons.

………………………………………………………………………………………………………………………
……………………………………………………………

………………………………………………………………………………………….

…………………………………… Date: ………………………………………..

Human Resources and Communications Director

Section C (to be completed by the Chief Finance Officer)

The application is within the approved budget and funds are available/not available to service the
purchase.

…………………………………… Date: ………………………………………..

Chief Finance Officer

Loan Details

Agreement No. ………………………………… Dated: ……………………………

Amount ZWL …………………… To be recovered at the rate of ZWL …………………… per month

For ……………. Months, commencing ………………… and ending ……………………….

Vehicles Details

Registration No. ………………….. Engine No. …….………………………………………..

Chassis No. …………………………………………………….

12/30/19 Approved by ………………………2nd Approval ………………….…………

Insurance Details
Insurer ………………………………… Policy No. ……………………………….

Amount Insured ZWL ………………………. Cover comprehensive

Insurance……………………………………… Date: …………………………..

Human Resources and Communications Director

12/30/19 Approved by ………………………2nd Approval ………………….…………