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Table of Contents

Lipa Na M-PESA Short Term Paybill

Medical Fund

Duly filled and signed Short term pay bill Application form and Terms and conditions stating purpose and duration.(Provided by Safaricom)
Copy of ID/Passport/Alien /Military card of the applicant
Certified supporting documents from the Hospital / Doctor treating the patient which should confirm the need for the collection e.g. reference to an operation/required treatment (on the institution’s letter head, stamped and signed by authorized personnel)

If applying on behalf of the beneficiary;
1. If a minor: the parents/guardian of the child should apply and a copy of the child’s birth certificate should be attached to the rest of the documents as listed
2. If the person is incapacitated: certified copies of IDs for the applicant will be required
Letter from the bank /cancelled cheque stating the bank details
Registered Safaricom line for settlement of funds (number to be indicated in the application

Duly filled and signed Short term pay bill Application form and Terms and conditions stating purpose and duration.(Provided by Safaricom)
Copy of ID /Passport/Alien /Military card of the
Certified Admission letter and fee structure(Either stamped or on institution letter head)
If applying on behalf of the beneficiary;
1. If a minor: the parents/guardian of the child should apply and attach a copy of the child’s birth certificate
Registered Safaricom line for settlement of funds (number to be indicated in the application form).
Letter from Bank or cancelled cheque confirming bank details

Duly filled and signed Short term pay bill Application form and Terms and conditions stating purpose and duration.(Provided by Safaricom)
Applicants copy of ID/ Passport/Alien /Military card
Copy of burial permit or copy of death notification
Registered Safaricom line for settlement of funds (number to be indicated in the application form).
Letter from the bank /cancelled cheque stating the bank details

Duly filled and signed Short term pay bill Application form and Terms and conditions stating purpose and duration.(Provided by Safaricom)
Letter from the institution that is to wed the couple stating the duration
Copies of ID / Passport/Alien /Military card for the couple
Registered Safaricom line for settlement of funds (number to be indicated in the application form).
Letter from the bank /cancelled cheque stating the bank details

Duly filled and signed Short term pay bill Application form and Terms and conditions stating purpose and duration.(Provided by Safaricom)
A covering letter from the committee stating the purpose of the Paybill and the Bank A/C details should be stated in the letter. At least two Committee officials to sign the letter
Letter from the bank /cancelled cheque stating the bank details
Registered Safaricom line for settlement of funds (number to be indicated in the application form).

Changa Na M-Pesa Application Form

Click here to access our self-onboarding portal for Lipa Na M-PESA

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