WaterKit Wallet Application Form

For Water User Committees. Complete this form to open a community WaterKit Wallet for collecting and managing handpump user fees.

A. Applicant Details (to be filled by the Water User Committee Chairperson)

Contact Details

Current Residential Details
B. Specimen
JPG, PNG or WEBP. Max 3MB.
Signing Mandate — Chairperson
JPG, PNG or WEBP. Max 3MB.
Signing Mandate — Secretary
JPG, PNG or WEBP. Max 3MB.
Signing Mandate — Treasurer
JPG, PNG or WEBP. Max 3MB.
C. Additional Requirements — Preferred Mode of Payment
Terms and Conditions for Water User Committees
1. Introduction

These terms set out the conditions upon which WaterKit will provide community Wallet services to the Water User Committee. All funds held in the WaterKit Wallet belong to the water handpump users of the community; WaterKit holds these funds in trust and has no claim or ownership over them.

2. Wallet Account Opening

The Committee's authorised signatories guarantee the accuracy of all information submitted. WaterKit may decline to open a Wallet account at its discretion and is not obligated to disclose the reason.

3. Wallet Operation Obligations

The Committee shall deposit all collected fees into the Wallet within five (5) business days, retain deposit confirmations, and keep all login credentials and PINs confidential. WaterKit may freeze the account in cases of dispute, fraud suspicion, or regulatory reason.

4–5. Complaints & Incident Communication

Complaints should be reported promptly through official channels. Any change of signatories, mandate, or Committee dissolution must be communicated in writing within fourteen (14) days.

6–7. Charges, Approval & Disbursement

WaterKit may debit the Wallet for approved repairs, service fees, and statutory levies. No funds are released without formal Committee approval via WaterKit Pay or in writing.

8–9. Reporting

Electronic statements are provided free of charge; records are retained for ten (10) years. Breakdowns must be reported within 48 hours.

10–13. Disclosure, Inactivity, Closure & Disputes

Account information is kept confidential except as required by law or this agreement. Wallets inactive for six (6) months require reactivation notice; eighteen (18) months of inactivity may result in dormant status. Closure balances are returned to the community within thirty (30) days. Disputes are resolved first by negotiation, then mediation, under the laws of Uganda.

Confirmation and Consent — Signatories
Chairperson — Confirmation
Secretary — Confirmation
Treasurer — Confirmation

The WaterKit Representative section will be completed by WaterKit staff upon review.