DECLARATION by alicejenny


									                                     ATHENA FACILITY

                                     Loan application form (*)




Type of investment project

Total investment amount (€)

Loan application (€)

Self-financing (€)

Technical Intervention Office CDE

Submission date of loan application

   (*) See appendix: “How to complete the loan application form”

  1                                         DECLARATION

I, the undersigned ………, acting on behalf of and for the company ……, hereby certify that the
information contained in this loan application is sincere and true.

I also declare:

       that the investment project described below meets the eligibility criteria of the
        ATHENA Facility;

       that the purpose of the loan application is fully in line with the Business Plan of our
        company ;

       that our company complies with legal requirements in matters of labour law, health and
        environment and that, in particular, we do not employ children in the course of our

       that our company will respond without delay, and in a sincere and comprehensive way,
        to any request for further information during the examination of this loan application.

I am aware:

       of the role played by BIO on the one hand, and by CDE and their local partners on the
        other, in the processing of the financing operation that is the subject of this application;

       that the loan application will be subject to an examination for which the information
        provided by our company will be treated as highly confidential and according to the
        strictest rules of professional conduct.

         In:                                        Date:




  2                 IDENTIFICATION

City – Country
Registration N°
Registration date

First name
Mobile phone

Bank name
Account N°
SWIFT code
Contact person

  3                          COMPANY

3.1. Presentation

3.2. Activities - Market

3.3. Internal organisation

3.4. SWOT analysis

3.5. Financial data

3.6. Bank relations

3.7. Compliance

3.8. Risks

  4                        INVESTMENT PROJECT

4.1. Project description

4.2. Financing plan

4.3. Investment loan

                    APPENDIX: How to complete the loan application form

General comments

       Be clear, precise and complete in your answers and explanations.

       Fill in the boxes in each section and increase their size if necessary.

       In your explanations, put yourself in the place of those analysing your application
        without having had the opportunity of meeting you.

       Do not hesitate to ask the Technical Intervention Office (TIO) of the CDE to help you
        complete the application form and prepare the appendices.

       Amounts relating to the investment project should be expressed in EUR. For conversion
        rates you may refer to the Web site:

Section 1: Declaration

       The declaration is to be signed by a director with authority to officially represent the

       It is important to note that any information which proves to be contrary to the truth will
        lead to the cancellation of the loan application or, if the loan has already been granted,
        will entitle the ATHENA Management Committee to withdraw the existing loan and
        demand its immediate repayment.

Section 2: Identification

       The contact person is the one who will receive any request for further information and
        who will also be the recipient of any correspondence from the lender.

       The bank details should be those of your usual banker and with whom the parties
        involved with ATHENA will monitor the credit risk of your company on an on-going basis.

Section 3: Company

3.1. Presentation

       Company: Constitution – Legal status– Official approvals - Capital development

       Shareholders: Name - Percentage capital held – Other professional activities – Integrity

       Managers responsible for day-to-day management: Professional skills – Integrity –
        Curriculum Vitae (to be attached as appendices)
       Personnel: Management – White-collar workers – Blue collar workers – Development -

       Does the company have an accountant? an auditor? an internal auditor? If yes, what are
        their eventual comments and assessments?

3.2. Activities – Markets

       Detailed description of the company’s activities

       Production and turnover for the last 3 years – Current order book

       Production process and main suppliers

       Characteristics of the market and main clients

       Main competitors – Development of sale prices in the sector

       Comparative advantages compared to competitors

       Current forecasts, without investment programme for partial financing for which this file
        is being submitted

3.3. Internal organisation

       General organigram

       Comments on management organisation

       Comments on marketing organisation

       Comments on technical organisation

       Comments on administrative organisation

       Is the continuity of the company guaranteed if key people leave, especially at
        Management level?

3.4. SWOT Analysis

       Explain, in a critical and realistic way, the strong and the weak points of your company,
        as well as what you plan to do, if relevant, to deal with those weaknesses.

       Explain, in a critical and realistic way, the opportunities in your market, as well as any
        threats to the development of your company.

3.5. Financial information

       Attach as appendices the most recent balance sheets and profit and loss accounts, or at
        the very least, the state of accountancy of your company.

       Comment on the sections of your financial statements which have recently shown
        significant development.

       Describe, if necessary, the seasonal nature of your cash flow. Make a special note of the
        periods of the year when cash-flow causes eventual difficulties.

       Explain any solvency, liquidity or profitability problems that your company may have
        had to face or still has to at the moment.

3.6. Bank relations

       Current bank relations: Bank(s) – Type of credit – Amount – Use to date

       Guarantees given to the bank(s)

       Have you experienced late repayments for previous loans? Have you requested, and
        obtained the restructuring of your banking commitments?

       What other banking products and services have you used?

       How could you describe your relations with your banker(s)?

3.7. Compliance

       Has the company been making late payments to the tax or social welfare authorities in
        your country?

       Has the company or its directors been the subject of a judicial sentence?

3.8. Risks

Summarise the main risks your company faces:

       Trading risks

       Technical risks in the production process

       Risks with regard to supply of raw materials

       Risks with regard to human resources

       Risks regarding financing working capital

       Exchange risks

       Risks linked to the economic and political situation

       Environmental risks

       Other risks

Section 4: Investment project

Based on the statements and questions below, describe your project in detail including its
financing plan and the parameters of the requested loan investment.

4.1. Description of the project

       What is the economic justification for the investment? Expansion of
        production capacity? Rationalisation of existing activities? Development of new

       What are the components of the investment (land, buildings, material, etc.) and their
        respective cost, before taxes and including taxes?

       Depending on the type of investment, have you carried out a preliminary feasibility
        study? If you have please attach it as an appendix.

       Does the investment project include investment in kind?

       What is the aim of the planned investment in terms of increase in turnover, or if
        relevant, reduction in operational costs?

       Will the investment involve purchasing material or raw materials abroad? Are there
        reputable local suppliers?

       Do you anticipate the recruitment of personnel?

       Expand on the financial information of your project (income growth and projected costs)
        in a business plan to be enclosed.

4.2. Financing plan

       Amount of the requested loan

       Amount and origin of additional financing: self-financing by the company? By existing
        shareholders? By new shareholders? Other sources of financing?

      What are the additional requirements in terms of working capital generated by the
       investment? How will it be financed?

      Have you discussed your project with your commercial bank?

      Do you agree to open a special account with your bank into which you will pay money
       on a monthly basis to meet the costs of the loan, and which will be debited when
       contractual repayments are due?

4.3. Investment loan

      Duration

      Repayment programme

      Grace period for repayment of the principal

      Direct debit programme proposal

      Proposed guarantees

      Any special conditions


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