Please enable JavaScript in your browser to complete this form. - Step 1 of 2Company Name *Address of Company *Address Line 1CityState / Province / RegionTITLE HELD IN BUSINESS *Telephone *Mobile *Fax:Company’s Principal Business *Years in BusinessType of CompanyMultinationalPublic Company (PLC)PartnershipSole proprietorshipPublic Company (PLC)Private Company (LTD)Ownership Structure100% Foreign AffiliatesNigerian with foreign Affiliates100% Nigerian (Limited Liability)100% Nigerian (Sole Proprietorship/Partnership)Company Size (Number of current staff)Is the Company quoted on Nigeria Stock ExchangeYesNoPrincipal Shareholders:Enter a comma separated list of shareholders and their percentage ownership e.g David Omole (34%)DIRECTOR PROFILEEnter a comma separated list of Directors Full name, professional qualifications ,country of origin and years of experience e.g Wole Sodemade CFA Nigeria 17 yearsSENIOR MANAGEMENTEnter a comma separated list of senior managers and their respective designation e.g Felix Usifo Ceo,NextCompany Contact Namefor Monitoring and Managing TransactionCompany Contact PhoneFINANCIAL INFORMATIONCompany AuditorsAuditors TelephoneAddress of AuditorsAddress Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateCompany Principal Bank(1)Bank AddressBank ContactContact TelephoneCompany Principal Bank(2)Bank AddressBank ContactContact TelephoneHave They Extended Any Credit Facilities to The CompanyYesNoProposed Tenor *TRANSACTION DETAILSDescription (Equipment Specification)Equipment PricePercentage Company Would FinancePreferred Length of Facility6-12 Months13-18 Months 19-24 Months25-30 Months31-36 Months37-42 MonthsPreferred Type of RentalMonthly QuarterlyBi-AnnuallyAnnuallyDECLARATIONI *FirstMiddleLastof the above information hereby undertake to repay /liquidate the loan facility ofCompany NameSignature * Click or drag a file to this area to upload. Passport * Click or drag a file to this area to upload. Utility Bill * Click or drag a file to this area to upload. Stamped Letter of Intent on Company Headed Paper Stating Intent to Acquire Lease Facility for Stated Equipment * Click or drag a file to this area to upload. Memorandum and Articles of Association and Certificate of Incorporation * Click or drag a file to this area to upload. Audited Financial Statements for The Last Three (3) Years * Click or drag a file to this area to upload. Current Stamped Bank Statements for The Last Six (6) Months * Click or drag a file to this area to upload. Identification card * Click or drag a file to this area to upload. PreviousSubmit