Bank Loan Application Form and Checklist

Company Letterhead

{{company_name}}

{{company_address}}

Phone: {{company_phone}}

Email: {{company_email}}

Website: {{company_website}}

Date of Application

{{date_of_application}}

Applicant Business Information

Legal Name of Business: {{business_legal_name}}

Trading Name (if different): {{business_trading_name}}

Registration Number (e.g., CIPC, Registrar of Companies): {{registration_number}}

Business Type (e.g., Sole Proprietor, Partnership, Pty Ltd): {{business_type}}

Date of Establishment: {{date_of_establishment}}

Physical Address: {{business_physical_address}}

Postal Address: {{business_postal_address}}

Contact Person: {{contact_person_name}}

Contact Person's Title: {{contact_person_title}}

Contact Number: {{contact_person_phone}}

Email Address: {{contact_person_email}}

Nature of Business/Primary Activities: {{nature_of_business}}

Loan Request Details

Loan Amount Requested: {{loan_amount_requested}}

Purpose of Loan: {{purpose_of_loan}}

Desired Repayment Period (in months): {{repayment_period_months}}

Proposed Collateral/Security Offered: {{collateral_offered}}

Financial Information Summary

Annual Revenue (Last Financial Year): {{annual_revenue_last_year}}

Net Profit (Last Financial Year): {{net_profit_last_year}}

Current Assets: {{current_assets}}

Current Liabilities: {{current_liabilities}}

Total Assets: {{total_assets}}

Total Liabilities: {{total_liabilities}}

Required Documentation Checklist

Please tick $(\checkmark)$ each item as confirmed and attached:

- [ ] Certified copy of Business Registration Certificate/Documents

- [ ] Certified copies of Identity Documents (IDs) of all directors/partners/proprietors

- [ ] Business Plan (detailing objectives, market analysis, operations, management, and financial projections)

- [ ] Latest Audited Financial Statements (for the past {{number_of_years}} years) or Management Accounts if audited not available

- [ ] Bank Statements (for the past {{number_of_months}} months) for main operating account

- [ ] Tax Clearance Certificate/Proof of Tax Compliance (e.g., SARS PIN)

- [ ] Resolution to borrow (for companies/close corporations)

- [ ] Collateral documentation (e.g., Title Deeds, Vehicle Registration Documents, Valuation Reports)

- [ ] Proof of Address for Business and Directors/Partners/Proprietors (e.g., utility bill)

- [ ] Schedule of existing loans/facilities with other financial institutions

Declaration and Authorization

I/We, the undersigned, declare that the information provided in this application is true and correct to the best of my/our knowledge. I/We understand that any false information may lead to the rejection of this application or legal action. I/We authorize {{bank_name}} to conduct credit checks and make any inquiries deemed necessary in assessing this application.

I/We have read and understood the terms and conditions relating to this loan application.

Signed at {{place_of_signing}} on this {{day_of_signing}} day of {{month_of_signing}}, {{year_of_signing}}.

For Bank Use Only

Application Received By: {{bank_officer_name}}

Date Received: {{date_received_by_bank}}

Application Status: {{application_status}}

Comments: {{bank_comments}}

Signature Block

___________________________

Signature of Applicant/Authorized Signatory

{{applicant_name}}

{{applicant_title}}

Date: {{signature_date}}