Financial Guide for SMEs - SME Corporation Malaysia

Financial Guide for SMEsSME FINANCINGAPPLICATION FORM(please use the Bank's own application form if there is one)BACKGROUND INFORMATIONName and Address of * Sole Proprietorship / Individual / Partnership / Corporation (or attach business card)Business Registration No /Certificate of Incorporation No* Please circle whichever is applicableSize of Business (tick where applicable)MicroSmallFor Primary Agriculture and Services Sector (including ICT)(Less than 5 employees or annual sales (Between 5 & 19 employees or annual salesturnover of less than RM200,000)turnover of between RM200,000 & less than RM1million)Medium(Between 20 & 50 employees or annual salesturnover of between RM1 million & RM5 million)For Manufacturing (including Agro-Based) and Manufacturing Related Services (MRS)(Less than 5 employees or annual sales (Between 5 & 50 employees or annual salesturnover of less than RM250,000)turnover of between RM250,000 & less than RM10million)N ature of BusinessYear of Commencement of Business(Between 51 & 150 employees or annual salesturnover of between RM10 million & RM25 million)Business Premise (tick where applicable)RentedOwnedNumber of EmployeesADDITIONAL INFORMATIONContact Person : Name and DesignationTelephone No / Fax NoHandphone NoE-mailFACILITIES REQUIREDTypeOverdraftTerm Loan (e.g. to finance purchase of factory, shoplots, etc)Trade Finance (please give details, e.g. Letter of Credit,Bills Negotiation, Trust Receipt, etc)Export Credit Insurance Trade FacilitiesForeign Exchange (Spot and Forward Contracts)Others (please specify)Please state the purpose of applying for the loanAmount (RM)Collateral to Offer (if any)CREDIT FACILITIES WITH OTHER FINANCIAL INSTITUTION(S) (please use a continuation sheet if necessary)Name of Financial Institution(s)Type of Facility(ies)Loan Amount (RM)SUPPORTING DOCUMENTSFor us to better consider your application, please provide the relevant documents.START-UPIn the event of a start-up (where the business has yet to commence or business has commenced for less than 12 months),please indicate which standard documents cannot be submitted by crossing them out from the checklist itself.DECLARATIONa) I / We hereby confirm that all information and supporting documents provided herein are true, correct and complete.b) I / We hereby give you my / our expressed consent to conduct any checking on my / our credit standing / financialstatus with any person /institutions/agencies that you may deem necessary including CCRIS, CTOS, SME/CentralCredit Bureau.c) I / We hereby agree the information relating to the facility may be forwarded by you to Central Credit Bureau and / orany other agencies / third party who may be entering into respective transactions with me / us.Authorised Signatory (Name & Position)NRIC No / Company ChopDate :123chapter 7-13 p79-181 Eng.indd 1238/15/11 5:03:01 PM