ANNEXURE II
BORROWER’S BASIC FACT SHEET- FOR CORPORATE
PRESCRIBED UNDER REGULATION R-3
Date of Request.
(TO BE COMPLETED IN CAPITAL LETTERS OR TYPEWRITTEN)
1. BORROWER’S PROFILE:
Name Address
Phone # Fax # E-mail Address
Office Res.
Computerized National Identity Card # National Tax # Sales Tax #
Import Export Date of Date of opening of A/c.
Registration # Registration # Establishment
2. NATURE OF BUSINESS:
Industrial Commercial Agricultural Services Any other
3. CORPORATE STATUS:
Sole Partnership Public/Private Limited Company
Proprietorship
4. DETAILS OF DIRECTORS/OWNERS/PARTNERS:
Name Address
Phone # Fax # E-mail Address
Office Res.
Computerized National Identity Card # National Tax #
Share-holding Amount % of Share-holding
5. MANAGEMENT:
A) EXECUTIVE DIRECTORS/PARTNERS:
Name Address CNIC # Phone #
1.
2.
B) NON-EXECUTIVE DIRECTORS/PARTNERS:
Name Address CNIC # Phone #
1.
2.
6. REQUESTED LIMITS:
Amount Tenor
Fund Based
Non-Fund Based
2. BUSINESS HANDLED/EFFECTED WITH ALL FINANCIAL
INSTITUTIONS DURING THE LAST ACCOUNTING YEAR:
Imports Exports Remittances effected (if any)
1
8. EXISTING LIMITS AND STATUS:
Status
Amount Expiry Regular Amount Overdue(if any)
Date
Fund Based
Non-Fund
Based
9. ANY WRITE-OFF, RESCHEDULING/ RESTRUCTURING
AVAILED DURING THE LAST THREE YEARS:
Amount during Amount during Amount during
Name of 1st Year 2nd Year 3rd Year
Financial Write- Rescheduled/ Write- Rescheduled/ Write- Rescheduled/
Institution off Restructured off Restructured off Restructured
10. DETAILS OF CLEAN FACILITIES CURRENTLY AVAILED:
A) AGAINST EXISTING FACILITIES:
Name of Financial Nature of Facility Total Limit Amount
Institution Outstanding
1.
2.
11. DETAILS OF PRIME SECURITIES MORTGAGED/ PLEDGED:
B) AGAINST EXISTING FACILITIES:
Name of Financial Nature of Total Rank of Charge Net Realizable
Institution Security Amount Value
3.
4.
B) AGAINST REQUESTED/ FRESH/ ADDITIONAL FACILITIES:
Name of Financial Nature of Security Total Amount Net Realizable
Institution Value
1.
2.
12. DETAILS OF SECONDARY COLLATERAL MORTGAGED/ PLEDGED:
A) AGAINST EXISTING FACILITIES:
Name of Financial Nature of Total Rank of Charge Net Realizable
Institution Security Amount Value
1.
2.
B) AGAINST REQUESTED/ FRESH/ ADDITIONAL FACILITIES:
Name of Financial Nature of Security Total Amount Net Realizable Value
Institution
1.
2.
13. CREDIT RATING (WHERE APPLICABLE):
Name of Rating Agency Rating
14. DETAILS OF ASSOCIATED CONCERNS
(AS DEFINED IN COMPANIES ORDINANCE, 1984):
Name of Name of Share-holding % of Total Share Capital
Concern Directors
2
15. FACILITIES TO ASSOCIATED CONCERNS BY THE CONCERNED FI:
Name of Nature & Outstanding Nature & Overdues Defaults
Concern Amount of as on-------- Value of
Limit Securities
16. DETAILS OF PERSONAL GUARANTEES PROVIDED BY THE
DIRECTORS/PARTNERS ETC. TO FIs TO SECURE CREDIT:
Names of Institutions/persons Amount of Validity NIC # NTN Net-
the to whom Guarantee Guarantee Period worth
Guarantors given
17. DIVIDEND DECLARED (AMOUNT) DURING THE LAST THREE YEARS:
During 1st Year During 2nd Year During 3rd Year
18. SHARE PRICES OF THE BORROWING ENTITY:
Listed Company Break-up Value of the Shares
Current Price Preceding 12 Months in case of Private Limited Company
Average
19. NET-WORTH (PARTICULARS OF ASSETS OWNED IN THEIR
OWN NAMES BY THE DIRECTORS/PARTNERS/PROPRIETORS):
Owner’s Name Particulars of Market value Particulars of Liabilities
Assets
20. DETAILS OF ALL OVERDUES (IF OVER 90 DAYS):
Name of Financial Institution Amount
21. Details of payment schedule if term loan sought.
22. Latest Audited Financial Statements as per requirements of Regulation R-3 to be submitted
with the LAF (Loan Application Form).
23. Memorandum and Articles of Association, By-laws etc. to be submitted by the borrower
along with the request.
24. I/We do hereby authorise the bank/DFI to share information about my pledged stock with
other banks/DFIs to monitor the position as per SBP Prudential Regulations.
I certify and undertake that the information furnished above is true to the best of my
knowledge.
CHIEF EXECUTIVE’S/
BORROWER’S SIGNATURE
& STAMP
COUNTER SIGNED BY:
AUTHORISED SIGNATURE &
STAMP
(BANK/DFI OFFICIAL)
3
4
