loan/investment application form for sme entrepreneur(s) · loan/investment application form for...
TRANSCRIPT
Date/ZvwiLt To/eivei
Head of Branch/e¨e¯’vcK ……………….Branch/kvLv Bank Alfalah/e¨vsK Avjdvjvn&
Dear Sir, I / We, the SME Entrepreneur (s), am / are applying for loan / Investment of BDT ………………… in the form of working capital / business expansion & purchase of Machineries / other purpose at your Branch……………… of your organization in favor of my / our enterprise for a period of ………………… months. Details of my / our personal, business related and proposed SME loan / Investment related information are provided below:
wcÖq g‡nv`q, Avwg/Avgiv GmGgB D‡`¨v³v wn‡m‡e Avcbvi cÖwZôv‡bi.........................................kvLv n‡Z Avgvi/Avgv‡`i cÖwZôv‡bi AbyK~‡j PjwZ g~jab/e¨emv m¤úªmviY I hš¿cvwZ µq/Ab¨vb¨ eve`................... gvm †gqv`x .....................UvKvi FY/wewb‡qvM Gi Rb¨ Av‡e`b KiwQ| wb‡†æ Avgvi/Avgv‡`i e¨w³MZ, e¨emv msµvš— Ges cÖ¯ZvweZ GmGgB FY/wewb‡qvM welqK Z_¨ †ck Kiv njt
Loan/Investment Application Form for SME Entrepreneur(s) GmGgB D‡`¨v³v wn‡m‡e FY/wewb‡qvM Gi Av‡e`b
1 Details of the Applicant Enterprise for loan/investment: FY/wewb‡qvM Gi Rb¨ Av‡e`bKvix cÖwZôv‡bi e„Ëvš— t 1.1 1.1
Name of Enterprise cÖwZôv‡bi bvg
: :
1.2 1.2
Address (Owned / Rented) wVKvbv (wbR¯̂/fvov)
: :
1.3 1.3
Nature of Business e¨emv‡qi cÖK…wZ
: :
□ Manufacturing □ wkí
□ Commercial □ e¨emv
□ Service □ †mev
1.4 1.4
Ownership Structure gvwjKvbvi aiY
: :
□ Sole-Proprietorship □ GKK gvwjKvbvaxb
□ Partnership □ Askx`vwi
□ Joint-Venture □ †hŠ_ g~jabx
1.5 1.5
Paid-up Capital e¨emvq wewb‡qvMK…Z g~jab
: :
1.6 1.6
Trade License No. & Expiry ‡UªW jvB‡mÝ b¤̂i I ‡gqv`
: :
1.7 1.7
Date of Incorporation e¨emv ïi“i ZvwiL
: :
1.8 1.8
TIN (Tax Identification Number) wUb (U¨v· AvB‡Ww›Uwd‡Kkb b¤̂i)
: :
1.9 1.9
Bank Account Type & Number e¨vsK wnmv‡ei bvg I b¤̂i
: :
1.10 1.10
Annual Sales of the Enterprise (where applicable) cÖwZôv‡bi evwl©K weµq (cÖ‡hvR¨ ‡¶‡Î)
: :
1.11 1.11
Annual Revenue of the Enterprise cÖwZôv‡bi †gvU evwl©K Avq
: :
1.12 1.12
Annual Expense of the Enterprise cÖwZôv‡bi †gvU evwl©K e¨q
:
1.13 1.13
Fixed Assets of the Enterprise (excluding Land & Building) cÖwZôv‡bi ’̄vqx m¤ú̀ (f~wg I BgviZ e¨ZxZ)
: :
1.14 1.14
No. of Employees at the Enterprise cÖwZôv‡b wb‡qvwRZ Rbe‡ji msL¨v
: :
1.15 1.15
Value of Inventory gRy` c‡Y¨i g~j¨
: :
2
Liabilities of the Applicant Enterprise: Av‡e`bKvix cÖwZôv‡bi `vq t 2.1 2.1
Bank / NBFI e¨vsK/A-e¨vsK Avw_©K cÖwZôvb
: :
2.2 2.2
Others Ab¨vb¨
: :
3 Details of the Applicant (In case of Partnership / Joint-Venture Enterprise, separate sheets to be added with similar information for other Sponsors) Av‡e`bKvixi e„Ëvš— (Askx`vwi/†hŠ_g~jabx Kviev‡ii ‡¶‡Î cwiPvjK‡`i Abyiƒc Z_¨ c„_K KvM‡R mshy³ Ki‡Z n‡e) 3.1 3.1
Name (in Bengali) bvg (evsjv)
: :
3.1 3.1
Name (in English) bvg (Bs‡iRx)
: :
3.2 3.2
Birth Date & Place Rb¥ ZvwiL I ’̄vb
: :
3.3 3.3
Academic Qualification wk¶vMZ †hvM¨Zv
: :
3.4 3.4
Training cÖwk¶Y
: :
3.5 3.5
Father's Name wcZvi bvg
: :
3.6 3.6
Mother's Name gvZvi bvg
: :
3.7 3.7
Marital Status ˆeevwnK Ae ’̄v
: :
3.8 3.8
Spouse's Name ¯̂vgx/ ¿̄xÕi bvg
: :
3.9 3.9
Present Address (including Phone No. & E-mail Address) eZ©gvb wVKvbv (†dvb b¤̂i I B-‡gBj AvBwWmn)
: :
3.10 3.10
Permanent Address ¯’vqx wVKvbv
: :
3.11 3.11
Income from Other Sources Ab¨vb¨ Drm n‡Z gvwmK Avq
: :
3.12 3.12
Ownership in Other Entities gvwjKvbvaxb Ab¨vb¨ cÖwZôv‡bi bvg
: :
3.13 3.13
TIN (Tax Identification Number) wUb (U¨v· AvB‡Ww›Uwd‡Kkb b¤̂i)
: :
3.14 3.14
NID (National Identification) Number RvZxq cwiPqcÎ b¤̂i
: :
4
Liabilities of the Applicant: Av‡e`bKvixi `vq t 4.1 4.1
Bank / NBFI e¨vsK/A-e¨vsK Avw_©K cÖwZôvb
: :
4.2 4.2
Others Ab¨vb¨
: :
5
Purpose of Loan/Investment: FY/wewb‡qvM MÖn‡Yi D‡Ïk¨ t 5.1 5.1
Working Capital PjwZ g~jab
: :
5.2 5.2
Business Expansion & Purchase of Machineries e¨emv m¤úªmviY I hš¿cvwZ µq
: :
5.3 5.2
Others Ab¨vb¨
: :
6 Details of Security (where applicable) Rvgvb‡Zi weeiY (cÖ‡hvR¨ †¶‡Î)
: :
7 Guarantor's Name Rvwgb`v‡ii bvg
: :
7.1 7.1
Details of Guarantor Rvwgb`vi m¤úwK©Z Z_¨
7.1.1 7.1.1
Name (in Bengali) bvg (evsjv)
: :
7.1.1 7.1.1
Name (in English) bvg (Bs‡iRx)
: :
7.1.2 7.1.2
Birth Date & Place Rb¥ ZvwiL I ’̄vb
: :
7.1.3 7.1.3
Academic Qualification wk¶vMZ †hvM¨Zv
: :
7.1.4 7.1.4
Father's Name wcZvi bvg
: :
7.1.5 7.1.5
Mother's Name gvZvi bvg
: :
7.1.6 7.1.6
Spouse's Name ¯̂vgx/ ¿̄xÕi bvg
: :
7.1.7 7.1.7
Address wVKvbv
7.1.7.1 7.1.7.1
Present (including Phone No.) eZ©gvb wVKvbv (†dvb b¤̂imn)
: :
7.1.7.2 7.1.7.2
Permanent ¯’vqx
: :
7.1.8 7.1.8
Occupation †ckv
: :
7.1.9 7.1.9
Monthly Income gvwmK Avq
: :
7.1.10 7.1.10
Guarantor’s Net Worth Rvwgb`v‡ii m¤ú‡`i cwigvY
: :
7.1.11 7.1.11
TIN (Tax Identification Number) wUb (U¨v· AvB‡Ww›Uwd‡Kkb b¤̂i)
: :
7.1.12 7.1.12
NID (National Identification) Number RvZxq cwiPqcÎ b¤̂i
: :
7.1.13
7.1.13
Bank Account Type & Number (if available) e¨vsK wnmv‡ei bvg I b¤̂i (hw` _v‡K)
: :
7.1.14 7.1.14
Loan/Investment Availed from Bank / NBFI e¨vsK/A-e¨vsK Avw_©K cÖwZôvb n‡Z FY/wewb‡qvM MÖn‡Yi cwigvY
: :
7.1.15 7.1.15
Others Ab¨vb¨
: :
7.1.16 7.1.16
Relationship with the Applicant Av‡e`bKvixi mv‡_ m¤cK©
: :
(If required, separate sheets to be added with this application form.) (cÖ‡qvR‡b c„_K KvMR mshy³ Ki‡Z n‡e)
_______________________ Guarantor Signature & Date
Rvwgb`v‡ii ¯̂v¶i I ZvwiL
[The applicant must provide any other information, proof, and documentary evidences to the Bank / NBFI necessary for sanctioning of loan / Investment.] [*FY/wewb‡qvM gÄywii Rb¨ Avek¨Kxq Ab¨ †h †Kvb Z_¨, cÖgvYcÎ Ges `wjjvw` e¨vsK/A-e¨vsK Avw_©K cÖwZôv‡bi Pvwn`v Abyhvqx MÖvnK cÖ`vb Ki‡Z eva¨ _vK‡e ]
(This Form is Free of Charge)/ (webvg~‡j¨ cÖ‡`q) ______________________ Applicant Signature & Date Av‡e`bKvixi ¯̂v¶i I ZvwiL