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Annex - N
CIB ONLINE INQUIRY FORM – 2
Institution’s (Borrower/Co-borrower/Guarantor/Owner) Information
Name of Bank/FI: Prime Bank PLC.
FI Code: 054 Branch Code: FI Subject Code:
*Type of Financing:
*Total Requested Amount/Credit Limit:
Installment contract data:
* Number of Installment:
* Installment Amount:
Periodicity of payment:
Institution (Proprietorship/Partnership/Company etc.) Subject Data:
Title:
*Trade Name:
(Trade name has to be filled up according to valid documentation(s), for example-Trade License/ Partnership Deed/ MOA, etc.)
*Legal form:
Proprietorship
Partnership
Pvt. Ltd. Co.
Public Ltd. Co.
Co-operative
Public sector
Multinational organization
NGO
Trustee organization
Others
ETIN:
RJSC Registration number (If available):
Registration date:
*Business Address:
*District:
*Street name & number:
Postal code:
*Country:
Factory Address:
*District:
*Street name & number:
Postal code:
*Country:
*Sector Type:
Public/Private
*Sector code:
Telephone number:
Date: Signature of the Customer
Seal of the institution
Seal and signature of the Seal and signature of the
Manager authorized officer
'*' indicates mandatory field