CREDIT APPLICATION FORM - INSTITUTIONS

Branch    
   
   
Section 1 (Company Details)
  
   
Name Of Institution
 
Nature of business
 
Registered Business Premises
 
Postal address
 
Telephone number(s) 
  
Fax number(s)
 
E-Mail Address
 
Bankers
 
Bankers branch
 
     
     
 
Section 2 (Details of Securities provided by the institution)
  
     
Do you presently own a house(s)?
 Yes No (If yes, please give details as below)  
House/Plot No
 
Location
 
Mortgaged
Yes No
  
If any of your houses are mortgaged, please indicate the details of the institution the are mortgaged to:  
 
     
     
 
Section 3 (Details of Directors/Trustees, etc)
  
     
Name
Nationality
Address
Fax
E-mail address
Telephone number
Bankers
   
     
Name
Nationality
Address
Fax
E-mail Address
Telephone number
Bankers
     
Name
Nationality
Address
Fax
E-mail address
Telephone number
Bankers
   
     
     
Has any of the directors ever been declared insolvent or assigned his/her estate or reached a compromise with creditors?
Yes No
 
If yes please give details below  
 
 
Give particulars of any civil judgment or writ of execution given within the past five years against the company or any of its directors
 
 
Give particulars of any other financial commitments, e.g. Hire Purchases, Bank Loans, et cetera  
     
Amount Borrowed
Amount Still Outstanding
Lending Institution
Details of Security
Purpose
   
 
Section 4 (Loan Details)

 

  
Amount required:
Cash deposit available from own resources:
Amount of loan required:
Repayment period preferred (in years):
   
 

Purpose for which loan is required (purchase, construction, property improvements, working capital, et cetera):

 
 

 
 
Section 5 (Additional information)

 

  
Do you have immediate cash resources for legal fees and valuation fees?
How much? (K)
 

 
 
Details of current investments with the Bank
 
Type Of Investment
Amount
Account Number
(K)
(K)
(K)
   
  If the loan is to be supported by a guarantee, the guarantor should indicate his/her willingness to act by giving the following details:
Full names
 
Residential address
  
Postal address
  
Telephone number