FUNDING APPLICATION QUESTIONNAIRE

Name of the Applicant:

Company:

Full Address:

Name of Managing Director (Contact Person):

Telephone:

Email:

Fax:

Country:

Loan Requested in Euro €:

Duration of Loan:

Type of Guarantee/Security Available:

Value of the Guarantee/Security (in Euro €):

Name of Valuer/Surveyor:

Is the Guarantee/Security free of all lien and charges:

Description of the Security/Guarantee/Assets
(Freehold or Leasehold):

Project Description:

Project Costs in Euro €:

Land Purchase €:

Land Development €:

Share Purchase  €:

Building/Construction €:

Plant and Equipment:

Vehicles: Working Capital €:

Professional Fees in  €:

Other Costs (Describe):

Is Planning (Government Approval) available for the Project:

What is the Project Owners contribution (in Euro €) towards the Project:

Any Pre-Sale Contracts or Guarantees:

Additional Information that may be relevant to the Project: