[Input]
Type of Financing: | Composit Loan
Loan/ Investment Amount: | Tk- 0
Number of Installment: | 0
Installment Amount: | Tk- 0
Periodicity of payment: | Monthly
Sector Type: | Private
Sector code: | 911000
PBL FI Subject Code (if any) | 0
Name | Title | Name
Name:
Type of Undertaker:
Role in the Institution:
Father’s Name | N/A
Mother’s Name | N/A
Husband’s Name | N/A
Permanent address
Street No/Village
Street ame/PS/Upazilla
District
Postal code
Country
Present Address:
Street No/Village
Street ame/PS/Upazilla
District
Postal code
Country
Business address:
Street No/Village
Street ame/PS/Upazilla
District
Postal code
Country
Date of Birth:
District of Birth
Country of Birth
National ID Number:
Other ID
ID number | N/A
ID issue date | N/A
ID issue country | N/A
TIN: | N/A
Gender:
Telephone Number:
The list of companies under the ownership of Undertker:
Serial No. | 1
Name of the Company
Main Address
Additional Address
Name of the bank/FI
Name of the branch
The list of companies under the ownership of Undertker:
Serial No. | 2
Name of the Company
Main Address
Additional Address
Name of the bank/FI
Name of the branch
[UNDERTAKING]
Annex-K
UNDERTAKING
Attachment-Ka
To
The Manager
Prime Bank Limited
Adamjee Court Annex Building-2,
119-120, Motijheel C/A, Dhaka-1000
Subject: Provision of information on the ownership of companies and their bank liabilities.
Dear Sir,
I, , of... ..., am applying for sanctioning/ renewal/ rescheduling of a loan in my own name/ aforementioned company’s name. My father’s Name: N/A, my mother's name: N/A, my husband’s name (in case of married woman) : N/A, Permanent address: Street No/Village , Street Name/PS/Upazilla: , District: , Postalcode - , Country - , Business Address: Street No/Village , Street Name/PS/Upazilla: , District: , Postal - , Country: , Date of Birth: , District of Birth: , Country of Birth: , National ID Number: , Other ID documents (Passport/Driving license /Birth Registration Certificate): ID number: N/A, ID issue date: N/A, ID issue country: N/A, TIN: N/A, Gender: , Telephone Number: , are given for your kind consideration. The list of companies under the ownership of mine along with their bank liability status is given in the following table:
Serial No. | Name of the Company | Main Address | Additional Address | Whether the company is availing any loan or not
Yes | No
Name of the bank/FI | Name of the branch
1 | - | - | - | - | -
2 | - | - | - | - | -
Apart from stated above, if any liability in my own name or my company’s name is found, I will be bound to obey any decision made by the authority concerned relating to sanctioning/renewal/rescheduling of the loan applied for and I will be punishable by law for providing this false or fabricated information.
Seal and Signature of the bank official who certified the borrower | Customer’s Signature: Name: Name of the Borrowing organization:
*If necessary, extra paper could be used for list of companies.
[CIB ONLINE INQUIRY FORM - 1]
Annex - N
CIB ONLINE INQUIRY FORM - 1
Individual's: | Information
Name of Bank/FI: | Prime Bank Limited
FI Code: | 054 | Branch Code:
*Type of Financing: | Composit Loan | *Total Requested
Amount/Credit Limit: | Tk- 0 | Amount/Credit Limit: | Tk- 0
Installment contract data:
Number of Installment: | 0 | Installment Amount: | Tk- 0
Periodicity of payment: | Monthly
Role in the Institution: | 0
(If the individual is an owner/director/partner of any company then select a role)
Individual Subject Data:
Title: | 0 | *Name: | 0
(Name has to be filled up according to NID/ other ID documents)
Father's Title: | 0 | *Father's Name: | N/A
Mother's Title: | - | *Mother's Name: | N/A
Spouse's Title: | - | Spouse's Name: | N/A
NID Number:
0
ETIN:
N/A
*Date of Birth: | 0 | *Gender: | 0
*District of Birth: | 0 | *Country of Birth: | 0
*Permanent Address:
*District: | 0 | *Street name and number: | ,
Postal code: | 0 | *Country: | 0
Present Address:
*District: | 0 | Street name and number:
Postal code: | 0 | Country: | 0
Other ID:
ID Type: Passport/Driving License/ | ID number: | N/A
Birth registration
ID issue date: | N/A | ID issue country: | N/A
*Sector Type: | Private | *Sector code: | 911000
Telephone number: | 0
Date: | Signature of the Customer
Seal and signature of the | Seal and signature of the
Manager | authorized officer
*' indicates mandatory field