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General
Name (s) *      
Email Address *      
Address *      
Activity *      
Product Line *      
Experience * (Years )    
No. of Employees *      
 
 
Ownership
Legal Status *    
Register No. *    
Paid-Up Capital    
Authorized Signature * 1    
2     
 
Jointly Individually
   
 
Main Owners' / Partners' / Shareholders' Names Born Register No. Position Shares
 
Requested Facility Details
Type Amount Period
Purpose        
Financing *
Machines & Equipment Raw Material
Products & Merchandise Installation & Fixtures
Other    
 
Current Banking Relations[All figures in US$]
Bank's Name *   Branch  
Date (From)   Date (Till)  
Credit Balance   Debit Balance  
 
Bank’s Name *   Branch  
Date (From)   Date (Till)  
Credit Balance   Debit Balance  
 
Bank’s Name *   Branch  
Date (From)   Date (Till)  
Credit Balance   Debit Balance  
 
Commercial Relations
Main Clients
Name 1   Balance 1  
Name 2   Balance 2  
Name 3   Balance 3  
Main Suppliers
Name 1   Balance 1  
Name 2   Balance 2  
Name 3   Balance 3  
 
Proposed Securities / Support
Mortgage Personal Guarantee Other
 
Main Financial Figures
Description In USD 31/12/2007 31/12/2006 31/12/2005
Net Revenues
Net Profit or Income
 
Description In USD 31/12/2007 31/12/2006 31/12/2005
Cash & Banks
Accounts Receivables
Inventory
Total Current Assets
Total Fixed Assets
Total Assets
 
Description In USD 31/12/2007 31/12/2006 31/12/2005
Due to banks
Payables
Total Liabilities
Owner's Equity
Total Equities & Liabilities
Owner's Worth
Plot N° Location Parts Area m2 Nature Status Estimation
 
Disclosure
Information held by the Bank, relating to a customer, will be kept confidential and will be used solely for customer profiling. Approval of any application is the sole discretion of LIB. Thank you for choosing LIB
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