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Diaspora Mortgage Application Form

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Diaspora Mortgage Application Form Powered By Docstoc
					                                                                                                         A/C Name…………………………………..
                       BUSINESS LOAN APPRAISAL FORM
                                                                                                         SAVINGS A/C NO………………………….




      LOANS IN THE OTHER BANKS/FINANCIAL INSTITUTION(S)

      Name of Lender               Amount advanced                 Date advanced                 Repayment period

      1

      2

      3

      Do you plan o n borrowing any money from ;

      shy locks ___________        NGOs __________ Banks ______________ Family members _________ others (specify)______________


      If yes please specify the purpose amount and repayment period

      (Attach bank statements)


1     ACCOUNT OPERATION AT EQUITY
      Average credit turnover - EBS (Last 6 mths) Kshs.
      Average credit turnover - Other banks/financial institutions (Last 6 mths) Kshs.
      Comments of the Appraisal/Loan officer



2     CREDIT HISTORY
                                      Amount        Payment
          Loan No.       Date                                       Period        Status                Performance
                                      granted        mode




3     NET HOUSE HOLD BUDGET
                         Monthly     Income                                       Monthly Expenses
      Other economic activities    Amount (Kshs)                Description                       Amount (Kshs.)
                                                                Rent
                                                                Salaries/Wages
                                                                Water, phone, electricity
                                                                Transport
                                                                Other loan repayment


      Total Income                                              Total Expenses
                                                                Net surplus/Deficit (Kshs.)
      NB: ** Supply copy of receipts or statement where applicable.
      Comments of the Appraisal/Loan Officer




4     BUSINESS FINANCIAL DETAILS
4.1   PROFIT AND LOSS
                            Income                                                Expenses
      Business sales                                            Purchases
      Other income (source/amount)                              Rents
                                                                Salaries/Wages
                                                                Others
      Total Income                                              Total Expenses
                                                                Net surplus/Deficit (Kshs)
4.2   BALANCE SHEET
                        Current Assets                                            Current Liabilities
Cash at Hand/Bank              Creditors
Debtors                        Bank Loans/Overdraft
Inventory (Work in progress)   Other Liabilities (specify)
Total Fixed Assets             Long Term Loans
Other Assets                   Capital




Total Assets                   Total Liabilities & Capital
4.3   DETAILS OF THE INVENTORY
          QTY                   DESCRIPTION             PRICE @ UNIT            TOTAL VALUE




5     RECOMMENDATION
                                CREDIT OFFICER        BRANCH CREDIT COMMITTEE
      Loan Amount
      LoanPeriod
      Payment Frequency
      Signature                                       STATUS      Approved   Rejected
      Name                                Signature               Date
      Branch Credit Committee
      Comments




                    Name                              Signature                     Date
      1
      2
      3
      4

      Comments




                    Name                              Signature                     Date
      1
      2
      3
      Head Office Credit Committee
      Comments




                    Name                              Signature                     Date
      1
      2
      3
         A/C Name…………………………………..

         SAVINGS A/C NO………………………….




                                       Outstanding amount




mbers _________ others (specify)______________
                                                                                                                         FOR OFFICIAL USE ONLY
                                                                                                                                       DATE:
                                                   DIASPORA                                                          Current/ Savings A/c No.:

                                                SME LOAN APPLICATION
                                                  MORTGAGE                                                                          BRANCH:

                                                                                                                         Sector Name & Code:

                                               APPLICATION FORM                                                      Sub-Sector Name & Code:

                                                                                                                       Industry Name & Code:

                                                                                                                           Nature of Advance:


1      CLIENTS PERSONAL INFORMATION                          (For Indiviuals & Sole Proprietorships ONLY)
       Applicant's Name:
                                                                                                          Date:
       (Mr/Mrs/Miss/Dr/Prof)
       Kenyan
                                                              Passport No.:                                                   Pin No.:
       ID No.:
       Marital
                            Single                                  Married                             Widowed                                      Divorced
       Status:
       Date of
                                                                                       Nationality:
       Birth:
              No. of dependants:                                                        Gender:          Female                                        Male
       Postal
                                                                                                          Email:
       Address:
       Tel. No.:                                                                  Current residence:
                                               Mobile No.:
       (landline)                                                                 (Attach sketch map)
       Spouse's
                                                                Kenyan ID No.:                                              Mobile No.:
       Name:

       Residence:                                                    Estate:                                                   Town:

       House No.                                                    Rented?                                                   Owned?

       Name of                                                                                                               Length of
                                                                  Phone No. :
       landlord                                                                                                             stay there?
       (NB: Attach all documents as required in Standard Requirements-Summary Form)

2      EMPLOYMENT DETAILS                      (If either applicant or spouse is employed)
       Name of
                                                                                  Employee's PF No.:                    Department
       Employer:
       Physical
                                                                                  Station
       address:
       Postal
                                                                                  Employment Terms
       Address:
       Tel. No.:
                                                                                  Designation
       (landline)

        Mobile No.:                                                               Length of Service

       (NB: Attach all documents as required in Standard Requirements-Summary Form)

3      BUSINESS PARTICULARS                      (For Companies, Partnerships, Clubs, Associations, Co-operatives & Others)
       Name of                                                                                                          Business Activity
                                                              Registration No.:
       Entity:                                                                                                          Type:

       Licence No.:                                                 Pin No.:                                                 VAT No.:

       Type of
                                                                                    Email Address:
       Entity:
       Postal
                           Current:                                                                     Permanent:
       Address
       Tel. No.:                                                                  Physical address:
                                               Mobile No.:
       (Landline)                                                                 (Attach sketch map)
       Physical
                            Town:                                    Street:                                                  Building:
       location

       Business Premises (current status)                           Rented?                              Owned?

       If rented,     Lease period:                           Remaining period:                         (Attach copy of rent agreement)          Rent Payable:

       (NB: Attach all documents as required in Standard Requirements-Summary Form)




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                                                                                                                       FOR OFFICIAL USE ONLY
                                                                                                                                     DATE:
                                                     DIASPORA                                                     Current/ Savings A/c No.:

                                                  SME LOAN APPLICATION
                                                    MORTGAGE                                                                     BRANCH:

                                                                                                                       Sector Name & Code:

                                                 APPLICATION FORM                                                 Sub-Sector Name & Code:

                                                                                                                      Industry Name & Code:

                                                                                                                         Nature of Advance:



4        CLIENTS PERSONAL INFORMATION
         PARTICULARS OF PROPRIETORS                         (For Indiviuals & Sole Proprietorships ONLY)
         Name of Director(s)/Partner(s)/Official(s)
                                   Name:                           ID No.:         PIN No.:            Tel No.:           Mobile No.:                  Postal Address:

                1


                2


                3


                4


                5

         (NB: Attach all documents as required in Standard Requirements-Summary Form)
5        EXPOSURE PARTICULARS
         LOAN PARTICULARS
5.1
         (indicate currency i.e. KES, US$, EUR)
             Loan Amount requested:                                                              Specific Purpose

                    Cost of project:                                                             Own contribution

                Repayment period:                                                                Monthly Instalment

5.2      ACCOUNTS IN OTHER BANKS/FINANCIAL INSTITUTIONS
                                             Bank                                             Branch                      Outstanding Balance (DR/CR)         Classification

                1


                2


                3


                4

5.3      LOANS IN EQUITY BANK
                                                                                                                                              Outstanding
                      Name of Branch & Borrower               Amount advanced Date Advanced     Loan Period           Installment                             Classification
                                                                                                                                              amount

                1


                2


                3


                4


                5

         (Attach Original certified bank statements as required)




      e2c6b246-4f37-4901-be2e-22d17d33f3a1.xls                                     8 of 11
                                                                                                                          FOR OFFICIAL USE ONLY
                                                                                                                                        DATE:
                                                     DIASPORA                                                         Current/ Savings A/c No.:

                                                  SME LOAN APPLICATION
                                                    MORTGAGE                                                                         BRANCH:

                                                                                                                          Sector Name & Code:

                                                 APPLICATION FORM                                                     Sub-Sector Name & Code:

                                                                                                                        Industry Name & Code:

                                                                                                                            Nature of Advance:



5.4      CLIENTS PERSONAL INFORMATION INSTITUTIONS & Sole Proprietorships ONLY)
         LOANS IN OTHER BANKS/FINANCIAL (For Indiviuals
                                                                                                                                                  Outstanding
                             Name of Bank                     Amount advanced Date Advanced       Loan Period            Installment                            Classification
                                                                                                                                                  amount

                1


                2


                3


                4


                5


                6

         (Attach Original certified bank statements as required)

6        REFEREES
                                            Names                                             Address                                   Telephone               Relationship

                1


                2


                3


                4

7        BUSINESS FINANCIAL DETAILS
7.1      PROFIT AND LOSS
                      Income                                  Actual          Projected                          Expenses                         Actual        Projected

         Business sales                                                                           Purchases


                                                                                                  Rents


                                                                                                  Salaries/Wages


                                                                                                  Transport


                                                                                                  Water, Phone, Electricity


                                                                                                  Others

         Total Income                                                                             Total Expenses

                                                                                                  Net surplus/Deficit (Kshs)

7.2      BALANCE SHEET
                      Assets                                  Actual          Projected                          Liabilities                      Actual        Projected

         Cash at Hand/Bank                                                                        Creditors


         Debtors                                                                                  Bank Loans/Overdraft

         Inventory                                                                                Other Liabilities
         (Work in progress)                                                                       (specify)

         Total Fixed Assets                                                                       Long Term Loans


         Other Assets                                                                             Capital

         Total Assets                                                                             Total Liabilities & Capital




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                                                                                                                                 FOR OFFICIAL USE ONLY
                                                                                                                                              DATE:
                                                       DIASPORA                                                             Current/ Savings A/c No.:

                                                    SME LOAN APPLICATION
                                                      MORTGAGE                                                                             BRANCH:

                                                                                                                                Sector Name & Code:

                                                   APPLICATION FORM                                                        Sub-Sector Name & Code:

                                                                                                                              Industry Name & Code:

                                                                                                                                  Nature of Advance:



  7.3      CLIENTS PERSONAL INFORMATION
           NET HOUSE HOLD BUDGET                             (For Indiviuals & Sole Proprietorships ONLY)
                   Monthly Income                              Actual               Projected                         Monthly Expenses                  Actual       Projected
           Borrower
                                                                                                          Rent
           (net salary)
           Spouse                                                                                         School fees
           (net salary)                                                                                   (Average per month)
           Business
                                                                                                          Transport
           (from 6.1 above)

           Pensions                                                                                       Water, Phone, Electricity


           Other Business income                                                                          Food


           Other income                                                                                   Other loan repayment

                                                                                                          Other expenses
                                                                                                          (medical etc)

           Total Income                                                                                   Total Expenses

                                                                                                          Net surplus/Deficit (Kshs.)
           (NB: Supply copy of receipts or statement where applicable.)

   8                                                                             PROPOSED GUARANTORS
           Name, Address Telephone Number (other contact information) and Relationship:




           Do any of these guarantors have existing direct/indirect liabilities with Equity bank? if so, what?

   9                                                                              SECURITY/COLLATERAL
           Kindly list all the securities giving details, description and serial numbers where applicable.
           DESCRIPTION OF THE ITEM                                                                                      SERIAL NO.                               VALUE(KSH)




With this signature I/We confirm that the above information given by me/us is the true and factual position of my/our business:-

                                                                                                                                    Company seal and/or Business' stamp affixed here




                                 Signature                                                   Date




                                 Signature                                                   Date


           (NB: For Limited liability company borrowers, the company seal be affixed to loan application form)



           I, ________________________________________________________ hereby, witness the signature of the applicant(s)



                                                                                                                 Customer's Segmentation:
           Signature of SME Relationship Officer                                             Date



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                                                                                                            FOR OFFICIAL USE ONLY
                                                                                                                          DATE:
                                               DIASPORA                                                 Current/ Savings A/c No.:

                                            SME LOAN APPLICATION
                                              MORTGAGE                                                                 BRANCH:

                                                                                                            Sector Name & Code:

                                           APPLICATION FORM                                             Sub-Sector Name & Code:

                                                                                                          Industry Name & Code:

                                                                                                              Nature of Advance:


   CLIENTS PERSONAL INFORMATION                          (For Indiviuals & Sole Proprietorships ONLY)
   LOAN APPLICATION DOCUMENTATION CHECKLIST
                                                                                                           SME RO's                 Manager's
   Item                                    Description                    Present           Absent
                                                                                                           Comment                  Comment
          1       Standard Requirements-Summary Form

          2       Credit Reference Bureau Report

          3       Introduction letter by Equity Bank Agent

          4       Summary Recommendation by Diaspora Mortgage Agent

          5       Valuation Report

          6       Sale Agreement (duly executed)

          7       Any other support document




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