APPLICATION FORM FOR LOAN (FY Mªn bi Rb Av e`b cî) (PLEASE FILL IN BLOCK LETTER AND USE SEPARATE SHEETS WHERE NECESSARY) (cö qvr b c _K cvzv e envi Kiæb) 1. Business Profile (e emv cwiwpwz): I. Name of the Company (cöwzôv bi bvg): II. Detail Address (c~y v½ wvkvbv): Factory (KviLvbv): Corporate office/ Head office (K cv iu/ nw Awdm): III. IV. Nature of Business (e emvi cök wz):.. Date of Incorporation (wbeü bi ZvwiL):./.../... Date of Commencement of Operation (evwywr K Drcv`b ïiæi ZvwiL):./.../... V. Legal Entity (AvBwb mëv): VI. Public Ltd. Co. cvewjk wjwg UW Private Ltd. Co. cövb fu wjwg UW Corporate Structure: ( Kv úvbx MVb) Partnership Askx`vix e emv Proprietorship e w³gvwjkvন axb Others Ab vb Name of the Shareholder (Askx`vixi bvg) Status in the Company (c`ex) Educational Background (wk vmz hvm Zv) Experience (AwfÁZv) Shareholding ( kqvi nvwìs) % Amount (Tk.) cwigvb (UvKv) Total ( gvu) Page 1 of 12
VII. Authorized Capital (Aby gvw`z g~jab): Tk..Million (wgwjqb UvKv) VIII. Paid-up Capital (cwi kvwaz gyjab): Tk..Million (wgwjqb UvKv)) IX. Company TIN ( Kv úvwbi Ki mbv³kib b ^i): X. Group/Sister Concern (s) (MÖæ ci Ab vb cöwzôvb) : Name and Address of Concern (cöwzôv bi bvg I wvkvbv) Nature of Business (e emvi aib) Year of Establishment (cöwzôvi eqi) Total Assets (Tk.) gvu m ú` (UvKv) Total Liabilities (Tk.) gvu `vq (UvKv) Annual Turnover (Tk.) evwl K weµq/uv bifvi (UvKv) Net Profit After Tax (Tk.) bxu gybvdv (UvKv) Page 2 of 12
XI. Please give details of the bank (s) where the applicant maintains an accounts ( h me e vs K cöv_x i wnmve Av Q Zvi weeiy): Name of the Bank (e vs Ki bvg) Branch (kvlvi bvg) Type of Account (wnmv ei cök wz) Account Number (wnmve bs) XII. Particulars of existing loan/lease facilities (if any) FY/ wjr& Gi weeiy (hw` _v K): Name and Address of the Bank/FIs (FY cö`vbkvixi bvg I wvkvbv) Nature of Financing (F Yi cök wz) Disbursement Date (FY cö`v bi ZvwiL) Tenure ( gqv`) Amount of Financing (cwigvb) Amount Outstanding (w wz) Security Provided (RvgvbZ) Page 3 of 12
2. Management and Personal (e e vcbv Ges gvbem ú` cwiwpwz): I. Key Management Profile (g~j Kg KZ v `i cwiwpwz): Sl. No. (µwgk bs) Name and Designation (bvg I c`ex) Educational Background (wk vmz hvm Zv) Experience (AwfÁZv) Monthly Salary (Tk.) (gvwmk ezb) II. Manpower Requirement (cö qvrbxq Rbej): a. Existing (ez gvb): Male (cyiæl): Female(gwnjv):..Total( gvu): b. Additional (AwZwi³): Male(cyiæl): Female(gwnjv)..Total( gvu) 3. Production Aspects (Drcv`b weeiy): I. For new industry/venture (bzzb wk íi Rb :): A. Production Capacity(Drcv`b gzv): Product (cy ) Installed Annual Capacity (evwl K ms vwcz Drcv`b gzv) Existing(eZ gvb) Additional(AwZwi³) Capacity Utilization Rate (Drcv`b gzv cª qv Mi nvi)(%) Page 4 of 12
B. Projected Production and Sales for next 5 (five) years (ciez x cvup erm ii Rb cöv wjz Drcv`b Ges weµq): Year (mvj) Items (cy ) Production Quantity (Drcv` bi cwigvb) Quantity (msl v) Sales(weµq) Amount (cwigvb) (amount in Tk.) (cwigvb UvKvq) Profit Earned (gybvdv) II. Actual Production and Sales for last 3 (three) years for the existing unit(ez gvb BDwbU jvi wemz wzb erm ii Drcv`b Ges weµ qi weeiy): (amount in Tk.) (cwigvb UvKvq) Year(mvj) Items (cy ) Production Quantity (Drcv` bi cwigvb) Quantity (msl v) Sales(weµq) Amount (cwigvb) Profit Earned (gybvdv) Page 5 of 12
4. Financial Aspects (Avw_ K weeiy): I. Investment Position(cÖv wjz wewb qvm): Particulars(weeiY) Local Currency ( `kxq gỳ ªv) Foreign Currency (we `kx gỳ ªv) Total Amount In Taka ( gvu UvKv) Land(f~wg) Land Development(f~wgi Dbœqb) Building(BgviZ / wewìs) Other Civil Works(Ab vb cyit/kvr) Imported Machinery and Equipment(Avg`vwbK Z hš cvwz I hš vsk) Local Machinery and Equipment( vbxq hš cvwz I hš vsk) Erection and Installation( vcb e q) Furniture and Fixture(AvmevecÎvw`) Vehicles(hvbevnb) Preliminary & Pre-operating Expenses(cÖv_wgK Ges c~e cwipvjb e q) Contingency(Awba vwiz / AvK w K e q IDCP(wb gvyvaxb mg qi mỳ ) Total Fixed Investment ( gvu vqx wewb qvm) Net Working Capital(PjwZ g~jab) Total Investment( gvu wewb qvm) Page 6 of 12
II. Means of Financing(A_ vq bi Drm mg~n): Source(Drm mg~n) Amount in Taka(UvKvi cwigvb) Sponsors Equity(D ` v³vi kqvi) Loan (FY) Lease Finance(BRviv A_ vqb) Credit from other sources (specify) (Ab vb Drm n Z FY) Total( gvu) % of Total Investment( gvu wewb qv Mi kzkiv nvi) 5. Technical Aspects (cöhyw³ MZ weeiy): I. Total land area (if Applicable) gvu Rwgi cwigvb (cö hvr n j): II. III. Major Raw Material(s) gyl KvuPvgvj mg~n (cö hvr n j): A. Particular(weeiY) B. Source(Drm/mieivnKvix) C. Price(g~j ) Utility Consumption(Avbymw½K e envi): Unit(GKK):Power(we` yr):...kw(wk jv IqvU), Gas(M vm):...cft.(wmgdwu) Water (cvwb):... Litre(wjUvi) Expense(e q/lip): Power(we` yr): Tk(UvKv)... Gas(M vm): Tk(UvKv)... Water(cvwb):Tk(UvKv)... 6. Marketing Aspects (evrvirvzkib weeiy): I. Consumer( fv³v): Local( `kx) Foreign(we `kx) ii. Demand Supply Gap(Pvwn`v I hvmv bi cv_ K ): Page 7 of 12
iii. Future Plan of the Company/Enterprise(cÖwZôv bi fwelr cwikíbv):......... 7. Financing Proposal to SABINCO(mvweb Kv _ K FY MÖn bi cö Íve): I. Types of Financing Required(F Yi cök wz / aib): Term loan( gqv`x FY) Working Capital(PjwZ g~jab) II. Financing Detail for Term Loan( gqv`x FY A_ vq bi we ÍvwiZ weeiy): A. Procurement of Asset (s) (please enclose quotation) m ú` / m úwë µq (g~j ZvwjKv mshy³ Kiæb): Description of Asset (s) (m ú `i No. of Units ( gvu Unit Price (Tk.) (BDwbU cöwz Total Price (Tk.) ( gvu Country of Origin (cö ZKviK Sources of Procurement (µ qi Drm) weeiy) cwigvb) g~j) g~j ) `k) Total( gvu) B. Amount of financing required ( gvu cö qvrbxq F Yi cwigvb): Tk(UvKv). C. Period of financing(f Yi gqv` Kvj):.years(eQi) Page 8 of 12
D. Moratorium Periods( gvivuwiqvg gqv` Kvj):.Months/years(gvm /eqi) E. Purpose of proposed Term Loan(cÖ ZvweZ gqv`x F Yi D Ïk ): a. For existing product line(ez gvb Drcv`b / mevi Rb ): Replacement of old machinery(cöwz vcb) Modernizing/Balancing(AvaywbKvqb/ ms vi) Expansion (m cömviy) b. Open a new production line(bzzb Drcv`b / mevi Rb ) III. Financing Detail for Working Capital(PjwZ g~jay A_ vq bi we ÍvwiZ weeiyt): a) Purpose(D Ïk ): b) Amount of financing required (A _ i cwigvbt): Tk(UvKv). c) Period of financing(a_ vq bi gqv`kvj):.years(eqi) IV. Security(RvgvbZ / eük): Cash Deposit (bm` A_ ) Lien of FDR ( vqx mâq/rgv) Land/Building (Rwg/f~wg) Saving/Unit Certificate (mâq/bdwbu mvwu wd KU) Bank Guarantee (e vsk M vivw U) Corporate Guarantee (K c v iu M vivw U) Personal Guarantee (e vw³mz M vivw U) 3 rd Party Guarantee (Z Zxq c M vivw U) Hypothecation (nvbcw_ Kkb) Page 9 of 12
Others (Specify) wewea(we ÍvwiZ)... I/We declare that the information contained herein is true and correct in every particular. I/We also hereby authorize you to verify our information and credit worthiness from any sources as you desire. Avwg / Avgiv GB g g cöz qb Kwi ZwQ h, Dc ivwj wlz mkj Z_ mwvk Ges wbf~ j Avwg / Avgiv GB g g Av iv D j L Kwi ZwQ h cö qvr b Avcbv `i cöwzôvb KZ K Avgv `i cö `q Z_ mg~ ni mz Zv wbiƒcy Ki Z cv ib On behalf of (c ) Signature ( ^v i).. Name (bvg). Date (ZvwiL) (Official seal) (Awdwmqvj wmj) Designation(c`ex). Page 10 of 12
Note: Please enclose the following - wb gèv³ cö qvrbxq Z_ vw` mshy³ Kwi Z nb e: 1. Memorandum and Articles of Association-msN ^vik I msn wewa. 2. Certificate of Incorporation-wbeÜb mb` 3. Board Resolution for availing financing from SABINCO and authorizing a person for execution of documentation and operation of the account (for limited company). -FY MÖn Yi Rb FYMÖnxZv cöwzôv bi ev W i Aby gv`b Ges evw KZ K Kvb mywbw` ó e w³ / e w³ em K F bi `wjjvw` ^v i Ges wnmve cwipvjbvi Rb AbygwZ cö`vb (wjwg UW Kv úvwbi Î) 4. Project Profile-cÖK íi cwiwpwz 5. Trade License (photocopy of original and updated copy)- UªW jvb mý (d UvKwc) 6. Financial statement for the last 3 (three) years. (if available)-avw_ K cöwz e`b - 3 eqi (hw` _v K) 7. Bank Statement for last 2 (two) years. (if available)- e vsk weeibx - 2 eqi (hw` _v K) 8. Tenancy Agreement of office/factory (if any)-fvovi Pzw³ cî (hw` _v K) 9. TIN certificate of the company-avqki mb` 10. Registration from Board of Investment-wewb qvm ev W i wbeüb cî 11. Site Clearance Certificate/Environmental Clearance Certificate from the concerned authority.-cwi ekmz QvocÎ Page 11 of 12
12. Land valuation Report (If applicable) f~wgi g~j vqb cöwz e`b (hw` _v K) 13. VAT certificate of the company.-f vu mb` 14. Proper certification from concerned Ministry/authority (if any)-h_v hvm KZ c i QvocÎ/mb` 15. Sanction Letter of existing loan/lease/lc Limit/other financing-c~ e i Kvb FY _vk j Zvi gäyix cî 16. Sales or Purchase contract (if any)-µq A_ev weµq Pzw³ (hw` _v K) 17. Detail Bio data of the sponsor(s) including academic background (please mention the name of degree, year of passing and institute), job and business experience-d ` v³v `i wk vmz hvm Zv, PvKwi I e emvwqk AwfÁZvi Rxebe ËvšÍ) weeiymn 18. Copy of National ID Cards of sponsor(s)/director(s).(rvzxq cwipq c Îi d UvKwc) Page 12 of 12