Application form for EEF:

(Specimen copy to be typed on letter head/pad) Date The Manager Bank/DFI/EEF

Subj: - Application for financial assistance. Dear Sir, We submit herewith an Application, together with a feasibility report on the project, for financial assistance for the project. A term-loan of Tk. ........................and a working capital loan of Tk. ............................. have been sought from your Bank/DFI. Besides, an equity-support of Tk. ..................... has also been sought from the EEF. 2. A Cheque/Pay Order for an amount of Tk. ............ (............................) only as PEF (Project examination fee), which is non-refundable, is enclosed herewith. 3. Besides, We undertake to deposit with you further amount of Tk........................ representing another 15% of our equity part after the sanction of the financial assistance. It is understood that the equity-deposits with you will be released to us for utilization in the proposed project after investment of the balance equity by us from our side to your satisfaction. Thanking you, Sincerely yours, Enclosed: As above.

Bank/DFI/EEF Unit Application Form for Financial Assistance For a New Project 1. (a) (b) Proposed Project : Name of the project : Location of the project :

(Please mention plot No., Mouza No., area, etc. and state whether land is free from encumbrance) 2. (a) (b) (c) (d) Form-4 Promoters : Bio-data of the promoters (sponsors)/ Directors as in Form-1 Personal net worth statement as in Form-2 Declaration of particulars of sister/allied concern(s) as in Form-3 A specimen of the letter to be addressed to the applicants Banker(s) as in

enclosing a copy thereof with this Application : (e) 3. (a) (b) Projects viability tests as in Form-5 Corporate set-up/constitution : Corporate set-up.(It has to be a private limited Company): Date of incorporation of the company:

(c) A copy of the Certificate of Incorporation (certified in the manner as stated against (d) below) of the company has to be enclosed with this Application. (d) A copy of the Memorandum and Articles of Association of the Company (certified by the Chairman /MD/Director of,or Secretary to, the company)has to be enclosed with this Application: (e) TIN of all Directors of the company and sister concern(s), if any, have to be furnished :

PARTICULARS OF PROJECT
4. A copy of the feasibility study (report) on the project showing interalia the following has to be submitted with this Application:A. Management : (i) Name of sponsor-Directors of the company, their background and experience. (ii) Comment on the management and financial capabilities and track record. (iii) Performance of other concerns, if any, where such Directors are involved. (iv) Details of foreign collaboration, if any. (v) Names of Directors who will be responsible for supervising the administrative and technical aspects, both at the implementation and production stages. B. (i) (ii) (iii) (iv) (v) (vi) (vii) (viii) items. (ix) Market : Proposed product-mix/service to be offered. Capacity to be developed. Existing demand along with future projection. Capacity already developed. Actual capacity utilization. Demand-supply gap. Pricing of proposed product/service. If the product/service is import-substitute, duty structure of imported Distribution channel.

C.

Technical : (i) Location-area of land and if development of land is required, the cost thereof. (ii) Communication facilities.

(iii)

Availability of utilities.

(iv) Civil works - Type of building and specifications of construction, covered area, estimated cost. (v) a) b) c) (vi) a) b) c) Plant and machinery (list of machinery to be enclosed) Imported machinery C&F cost Other costs Country of origin Local machinery. Erection and installation. Technology transfer, if any Raw materials Imported C&F cost Duty and taxes Other costs Local raw and packing materials Manpower

(vii)

Category Managerial and technical Administrative and sales Labour: Skilled Semi-skilled Unskilled
(viii) (ix) Furniture and fixture Office equipment

No.

Salary and allowances per month

(x) (xi) (xii) (xiii)

Transportation Safety provision Waste disposal Implementation schedule

D. E.

Financial Assumption for financial analysis Cost of the project and means of finance Estimate of working capital Sales estimate Projected income statement Cost of service/goods sold Gen., administrative and selling expenses Break-even analysis Pay-back period Cash-flow statement Projected balance sheet Debt-service coverage ratio Internal rate of return Ratio analysis Sensitivity analysis

aspects

Economic aspects : No. of jobs created Cost per job created

Contribution to GDP Earning in foreign exchange or foreign exchange savings.

F.

Other relevant information :

We do hereby solemnly declare and affirm that the statement and information furnished in this Application and the Forms and the feasibility report enclosed herewith are correct and true, and nothing has been concealed therefrom, and if at any time it transpires that we have suppressed any fact and/or supplied wrong information, we shall be held liable therefor. We agree to furnish you any further information as may be required by the Bank/DFI. Name and Designation Signature 1. 2. 3.

Date :

FORM-1
Form-1(a) Name of the company : BIO-DATA OF THE SPONSORS/DIRECTORS (Please use separate sheet(s) for each Sponsor/Director)

PHOTO

1. 2. 3. 4. 5.

Name : Father's/Husband's name Nationality Age/Date of birth Address (a) (b) : : : Present : :

Permanent (Citizenship Certificate from Commissioner has to be enclos the Union Council Chairman/Ward

6. 7. 8.

Home District

: :

Educational qualifications

Technical or any other qualifications(Please specify)

Form-1(b)

9.

Industrial/Business/otherexperience in (Name and nature of business/industry, its location/address, main products and detailed experience, i.e. nature duration with dates, etc. are to be specifically mentioned) : Are you associated with any projects by Bank/DFI? If so, please state the name of the company and extent of your shareholding : Any other information :

details of job,

10.

financed

11.

DECLARATION I do hereby declare thati) ii) I am a bonafide national of Bangladesh; I am not a minor;

iii) neither I am nor my spouse is serving with any Government/SemiGovernment/Autonomous Body; and iv) the particulars furnished above are true and correct.

Signature of the Sponsor/Director Date :

FORM-2

Form-2(a) PERSONAL NET WORTH STATEMENT

NAME ________________________

S/D/O___________

W/O _______________ ADDRESS _____________________ AGE _______________ PROFESSION_________

_______________________________ POSITION________________ MARITAL STATUS ________ CHILDREN : MALE ____FEMALE_______

For the purpose of obtaining financial assistance from time to time in any form whatsoever from the Bank/DFI/EEF, the undersigned submits the following as being a true and accurate statement of his/her financial condition on the date mentioned herein and also agree that if any change occurs, the undersigned will immediately notify the same to the Bank/DFI/EEF :-

Form-2(b)

NETWORTH STATEMENT AS ON ______________________

_____________________________________________________________
LIABILITIES ASSETS

CASH

Loan from Banks/Financial Institutions a) (Schedule-A) Secured Tk._____________ b)

In hand

Tk._________

With other Banks

Tk.__________

UnsecuredTk._____________

INVESTMENT

Other Creditors Unpaid taxes

Tk.____________ Tk.____________

Government securities Shares, Debenture, Bonds, etc. Debtors Real estate (encumbered) (Schedule-B)

Tk._________

Tk._________

Tk._________

Real estate (unencumbered) (Schedule-C ) Tk._________

Other liabilities (Details attached) Tk.__________

Cash surrender value for Life Policy Tk._________

Others (Details attached)

Tk._________

TOTAL

TK. ________

TOTAL

TK.____________________

NETWORTH (Total Assets - Total liabilities)

Tk. __________________________

Form-2(c)

Name of the Company

SCHEDULE-A LIABILITIES TO BANKS/FINANCIAL INSTITUTIONS: Name & address of the Bank/Financial Institution Date of availing Of the loan Limit with validity Present outstanding Secured or unsecured with nature of security

SCHEDULE-B REAL ESTATES (ENCU MBERED) Location and tenure of ownership Area of land Description and Schedule of the Property and type of building Mortgage and mortgage amount Market price Land Building Total

SCHEDULE-C REAL ESTATES (UNENCUMBERED)

Location and tenure of ownership

Area of land

Description and Schedule of the property and type of building

Market price Land Building Total

Form-2(d) DECLARATION (a) I do hereby declare that I have/do not have liabilities to any of the above named Banks/DFIs in my name or in the name of any company/concern in which I hold interest; I do hereby declare that the above named assets are owned by me; and

(b)

(c) I do hereby declare that my Income Tax (Payer's) Identification Number (TIN) is/are ______________________ and Income Tax liabilities is/are clear up to the assessment year ______________(photo copies o tax payment documents f is/are enclosed).

The undersigned certifies that the information furnished herein is true and correct.

Date :

Signature of the Sponsor/Director

FORM-3
Form-3(a) Name of the Company Bank/DFI/EEF

Subj : Declaration of particulars of sister/allied concern(s) Dear Sir, I do hereby declare that the particulars of my sister/allied concern(s) is/are as follows:(1) (2) (3) (4) Name of business concern(s) : Name of the proprietor/partners/ Directors : Business address Father's/Husband's name of the proprietor/partners/Directors : (5) Residential address of the proprietor/partners/Directors : (6) Name of the Banker : :

Form-3(b) (7) Position of loans/liabilities Amount : Present outstanding Security

Nature of loan

I confirm that I have no other sister/allied concern and liabilities beyond those as declared herein.

Date___________

Signature of the Sponsor/Director

Note: Please use additional sheets/papers, if necessary.

FORM-4
Form-4 SPECIMEN LETTER TO BE USED FOR AUTHORIZATION OF THE BANKER (To divulge confidential information) Date : Manager, ___________________Branch ____________________Bank

Dear Sir, Account No. I/We have applied to the Bank/DFI/EEF for financial assistance 2. In this connection, I/We hereby authorize you to furnish to them any information they may request from you regarding the conduct of the account(s) and loans/facilities that have been extended to me/us by your Bank/DFI.

________________________ Signature of Account Holder _____________________ Name of Account Holder

Signature Copy to the Bank/DFI/EEF.

FORM-5
Form-5(a) Project's viability tests In appraising a project (1) the highest importance shall be accorded to the appraisal of the

sponsors/entrepreneurs, which shall include inter alia a. b. c. d. e. f. their educational qualifications in the relevant discipline; their knowledge in the technology/process involved; their skill in marketing of the products/services in question; their proven track record in implementing and operating any project; their track record in financial conduct; their track record of relationship with any Bank/DFI;

(2) the project shall be technically sound and technologically appropriate for Bangladesh and environment friendly; (3) the project shall be financially feasible and offer an Internal Rate of Return (IRR) of not less than 15% (fifteen percent); (4) the project shall generally generate a minimum of 15% (fifteen percent) per annum after tax return on its paid-up capital from the 3rd year of operation;

Form-5(b) (5) where the project is also financed by loan (s), its projected debt service coverage ratio shall not be less than 1.50 times and its current ratio not below 1.5 : 1, and its fixed assets coverage ratio (during the currency of such loan(s)) shall be at least 1.50 times; (6) in the case of the project at (6) above, the sponsors' stakes therein i.e. their equitycontribution thereto may vary corresponding to (a) the degree of risk inherent in the project; and (b) the known debt-equity ratios for the successful units in the same sector; and (7) Any other relevant aspects of the project such as SOWT (strengths, weaknesses, opportunities and threats) analysis, sensitivity analysis, etc.