Bank of India (Uganda) Ltd

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Bank of India (Uganda) Ltd APPLICATION FORM FOR CREDIT FACILITIES (BUSINESS ENTERPRISE) Passport Photo Passport Photo To be submitted along with documents as per the check list Application date / / Amount requested New/Repeat Borrower 1. Business name 2. Registered office address: Postal Town District Physical Address of Factory/shop 3. Date of registration / / Registration no. 4. Residential status of applicant (whether resident in Uganda or not) 5. Contact details Telephone: Office Mob Email address: CRB Card No. 6. Constitution (Proprietary/partnership firm/private Ltd/limited Company/Co-op society) 7. Date of establishment of enterprise: 8. NAME OF PROPRIETOR/PARTNERS/DIRECTORS OF COMPANY AND THEIR ADDRESS Name Date of Birth Academic qualification Residential address Tel no. (res) Experience in the line of activity 9. Relationship of Proprietor/Partner/Director with the officials of the Bank/Director of the Bank

10. NAMES OF ASSOCIATION CONCERNS AND NATURE OF ASSOCIATION: Name of the Associate concern Addresses of the Associate Concern Presently Banking with Nature of Association Extent of Interest as a Prop./Partner Director/ or Just investor in Associate concern 11. Existing Credit facilities 11 (a) Type of facilities Limits (in million) Outstanding as on Availing from Security lodged ROI Repaym ent terms Current Account Cash Credit Term Loan LC/BG 11(b) If Banking with this Bank, customer No. to be given, It is certified that our unit has not availed any loan from any other Bank/Financial Institution in the past and I am no indebted to any other Bank/Financial Institution other than those mentioned in 10(a) above. 12 CREDIT FACILITIES REQUESTED FOR Type of Amt. (In Purpose for Facilities Millions) which required Overdraft facility Security offered (details with approx. value to be specified) Primary Provide the details of security collateral security (Proposed) Term Loan LC/BG 13. Details of the Existing accounts of the Company / Firm / Individual Name of the Bank Type of the Account Banking Since Title of the Account Directors/ Owners of the Company/ Firm

14. Details of guarantor(s) Name Residential Address Occupation (If in service, name & address of his/her employer) _ Details of any similar guarantee, if any, given to other institutions Whether any Government enquiry, proceedings or prosecution has been instituted against the unit or its proprietor/partners/directors/guarantors for any offence? Yes No If Yes, please give details. Details of pending litigation, if any, against and by the Unit / Directors / Guarantors. _ 15. In case of term loan requirements, the details of machinery may be given as under; Type of Machine Purpose for which required Whether imported indigenous or Name of supplier Total Cost of the Machine Contributions being made by the Promoters Loan required. 16. Details of collateral security offered 3. PAST PERFORMANCE/FUTURE ESTIMATES (Actual performance for two previous years, estimates for current year and projections for next year to be provided for working capital facilities. However for term loon facilities projections to be provided till the proposed year of repayment of loan) Past Year II (UGX Millions - Actual) in Past Year I (Actual) Present Year (Estimates) Next Year (Projections) Net Sales Net Profit Capital (Net Worth in case of companies)

Monthly Turnover of last twelve months 14 Status regarding statutory obligations Statutory Obligations 1. Registration with ROC and or license from government to transact the business 2. Registration with UIA if any Whether complied with (Write Yes/No). If not, applicable then write NA Remarks (Any details in connection with the relevant obligation to be given)/ Number 3. Trading license 4. Vat Registration 5. Latest Income Tax return filed 6. Any other statutory dues remaining outstanding I/We the undersigned, certify that all information furnished by me/us is true; that I/We have no borrowing arrangements for the unit except as indicated in the application; that there is no overdue/statutory dues against me/us/promoters except as indicated in the application; that no legal action has been/is being taken against me/us/promoters that I/We shall furnish all other information that may be required by you in connection with my/our application that his may also be exchanged by you with any agency you may deemed fit and you, your representatives,. representatives of the Reserve Bank of India or any other agency as authorized by you, may at any time, inspect/verify my/our assets, books of account etc. in our factory/business premised as given above. Signature of the Proprietor/Partner/Director/guarantor whose photos are affixed above Signature........ Name..... Date.........

Annexure -1 BIO-DATA FORM: Director / Partner / Guarantor / Individual 1. Full Name 2. D.O.B / / Sex: 3. Name of the Father/Spouse 4. Type of Identification and No.: Passport Driving License Gov t Identity Card Financial Card Other (Specify) 5. Type of employment: Formal employment self-employed Informal employment Un employed Occupation: Employer: Postal address Physical address: Tel contact 1. 2. 3. If self-employed, nature of work and location: 6. Residential address: LC1 Town District Period at address (years) Status : Owner Tenant 7. Functional Responsibilities in the unit (Organization) 8. Capital/Loan Contribution in the unit at present _ If associated as proprietor/partner/director/shareholder with concerns other than the applicant unit, please furnish following details 9. Name and address of the branch/associates/identical concern 10. Functional responsibility in that concern: 11. Capital/Loan Contribution:

12. Name of the associate concern s Banker and their address: 13. Aggregate credit facilities enjoyed by the concern: 14. Security offered by the concern for its borrowing: 15. Personal Assets and Liabilities: Assets 1) 2) 3) 4) Liabilities 1) 2) 3) 4) 16.1 Immovable property details like land/buildings, Location, date of acquisition, cost, present value etc. Asset Date of acquisition Cost Present Value Other Assets 16.2 Personal Liabilities, if any. (Including guarantees/acceptances given 17. Any other relevant information Signed at, Date Signature

CHECK LIST (TO BE GIVEN TO THE CUSTOMERS BY BRANCH) OF DATA TO BE KEPT READY BY THE CUSTOMER 1. Proof of identity Passport / Driving License / signature identification from present bankers of proprietor, partner or Director (if a company). 2. Proof of residency LC Certificate, Tenancy Agreement, Copy of utility bills, property tax receipt/voter s ID Card of proprietor, partner or Director (if a company) 3. Proof of business address Form 8, or tenancy agreement etc., 4. Copies of Form 7, Trading license, Date of incorporation, Registration of firm etc., 5. Last three years balance sheets of the units along with income tax/sales tax returns etc. 6. Memorandum and articles of Association of the Company/Partnership Deed of partners etc. 7. Assets and liabilities statement of promoters and guarantors along with latest income tax returns. 8. Statutory clearances like KCCA permission, NEMA, UNBS, etc., 9. Projected balance sheets for the next two years in case of working capital limits and for the period of the loan in case of term loan 10. Statement of accounts from the existing bankers for the last 6 months 11. In case of takeover of advances, sanction letters of facilities being availed from existing bankers/financial Institutions along-with detailed terms and conditions. 12. *Profile of the unit (includes names of promoters, other directors in the company, the activity being undertaken, addresses of all offices and plants, shareholding pattern etc. 13. Review of account containing month-wise sales (quantity and value both), production (quantity and value), imported raw material (quantity and value), indigenous raw material (quantity and value), value of stocks in process, finished goods (quantity and value), debtors, creditors, bank s outstandings for working capital limits, term loan limits,bills discounted. 14. Photocopies of title deeds/ long term lease deeds/title deeds of all the properties being offered as primary and collateral securities. (The Check list is only indicative and not exhaustive and depending upon the local requirements at different places addition could be made as per necessity).