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NGN HNG TMCP I

CHI NHNH :

CNG HA X HI CH NGHA VIT NAM


c lp T do Hnh phc
., ngy .. thng .... nm .

T TRNH THM NH TN DNG


(p dng i vi khch hng c nhn vay tiu dng)
Knh trnh : .
Ngy nhn h s:...................; Ngy nhn h s: .................; Ngy hon tt h s: ................
I.

THNG TIN KHCH HNG


-

Khch hng: - Nm sinh : .. -(.tui) Gii tnh: ..............

CMND/H chiu/MST: . ngy cp : ti: .......................

a ch lin h: ..............................................................................................................

in thoi: .....................................................................................................................

Tnh trng s hu: .........................................................................................................

Tin nghi sinh hot: .......................................................................................................

Mi trng sng: ...........................................................................................................

Ngh nghip: .................................................................................................................

H tn ngi hn phi: ................................... Nm sinh: .........................................

CMND/H chiu: . ngy cp : ti: .................................

Ngh nghip: .................................................................................................................

ng k vay: (c th m t nhiu ngi ng k vay)


-

Khch hng: - Nm sinh : ..-(.tui) Gii tnh : ..............

CMND/H chiu: . ngy cp : ti : ................................

a ch lin h: ..............................................................................................................

in thoi: .....................................................................................................................

Tnh trng s hu: .........................................................................................................

Tin nghi sinh hot: .......................................................................................................

Mi trng sng: ...........................................................................................................

Ngh nghip: .................................................................................................................

Nhn xt t cch khch hng:


-

Tranh chp php l : ......................................................................................................

Mc hp tc : ............................................................................................................

Trung thc : ...................................................................................................................

Ch k NVTD/PT:_______________
Mu t trnh c nhn vay tiu dng

Ch k TBP/TP:_______________
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II.

Nhn xt khc v khch hng: .......................................................................................

M T V NHN XT PHNG N S DNG VN VAY


1.

Nhu cu cp tn dng: .................. (Mc ch s dng vn th 1)


- Mc ch s dng vn: .................................................................................................
- Thi hn: - n hn vn: . n hn li: .
- Phng thc tr n : .....................................................................................................
- Tng vn (u t): ........................................................................................................
- Vn hin c: .................................................................................................................
- T l vn vay/tng vn (u t): ..................................................................................
- Din gii mc ch s dng vn: .................................................................................
- Chi tit s dng vn: ....................................................................................................
- ngh khc ca khch hng (lin quan n phng n s dng vn):......................
- Nhn xt v tnh xc thc ca phng n vay: ........................................................
- Nhn xt v tnh hp l ca phng n vay: ...........................................................
- Nhn xt v tnh hp php ca phng n vay: ......................................................
- S ph hp vi chnh sch/sn phm tn dng ca i Ngn hng: .................
- Bin php kim sot mc ch s dng vn vay : .

2.

Nhu cu cp tn dng : (Cho mc ch s dng vn th 2 n)

III. LCH S/UY TN GIAO DCH CA KHCH HNG


Khch hng: ........................................................ (c th m t giao dch ca nhiu ngi)
Tin gi thanh ton/tin gi tit kim :
Tn t chc tn dng

Loi tin

S d

S d cao nht

hin ti

S d

Nm m

bnh qun nm

ti khon

NH ...
TNG CNG (# VN)

(Ch lit k cc ti khon tit kim pht sinh trong 12 thng gn nht hoc cn s d hin ti)

Tn dng:

Tn t chc

Mc cp tn

Loi

D n

Mc ch

Ngy

Ngy

Ngy

tn dng

dng ban u

tin

hin ti

vay

vay

o hn

thanh l

NH: .
TSB:
Ch k NVTD/PT:_______________
Mu t trnh c nhn vay tiu dng

Ch k TBP/TP:_______________
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Tng d n hin ti cc TCTD khc (# VND) ........................................................ ng

Tng d n hin ti i Ngn hng (# VND): .................................................... ng

Tng mc cp TD cao nht c i Ngn hng duyt (# VND): ................... ng

Tng mc cp tn dng hin ti i Ngn hng (# VND): ................................. ng

Tng gi tr TSB hin ti i Ngn hng (# VND): ........................................ ng

T l Tng mc cp tn dng/TSB hin ti i Ngn hng %

Nhn xt lch s/uy tn giao dch:


- Quy m tin gi thanh ton/tit kim: .................................................................................
- N t nhm 2 n nhm 5 trong 12 thng gn y: ............................................................
- Mc s dng vn vay ng mc ch cc khon vay trc: ..........................................
- Mc tun th iu kin cc khon vay trc: .................................................................
- Kh nng s dng cc sn phm khc trong tng lai: .......................................................
IV. TNH HNH TI CHNH C NHN CA KHCH HNG
TI SN

NGUN VN

Tin mt

Vay ngn hn

Tin gi ngn hng

Vay trung/di hn

Tin ang chuyn

Cc khon phi tr khc

Chng khon

Vn ch s hu

u t/gp vn

Khon phi thu

Phng tin i li

Bt ng sn

Khc

TNG CNG:

TNG CNG:

(Bng ny th hin tnh hnh ti chnh chung ca c nhn ngi vay/ngi hn phi)
Din gii chi tit v ti sn c v ti sn n:
Ch k NVTD/PT:_______________
Mu t trnh c nhn vay tiu dng

Ch k TBP/TP:_______________
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Tin mt: ...............................................................................................................................

Chng khon: ........................................................................................................................

u t/gp vn: ....................................................................................................................

Khon phi thu: .....................................................................................................................

Bt ng sn: .........................................................................................................................

Phng tin i li: .................................................................................................................

Ti sn khc : ........................................................................................................................

Vay ngn hn: .......................................................................................................................

Vay trung/di hn: .................................................................................................................

Cc khon phi tr khc: .......................................................................................................

Nhn xt/nh gi:

V.

Tng ti sn: ..........................................................................................................................

N/Tng ti sn: ....................................................................................................................

Nhn xt/nh gi nng lc ti chnh ca KH: ................................................................


NGUN TR N
1. Ngun thu nhp: (C th m t nhiu ngun thu nhp ca nhiu ngi)
n v: VND
KHCH HNG: ...........................................
THU NHP HNG THNG:(M t cc ngun thu nhp c chu k l thng)..
Ngun thu nhp 1,2 . . n:
.........................................
M t: ..........................................................................
THU NHP HNG QU:(M t cc ngun thu nhp c chu k l qu):..
THU NHP KHC (M t cc ngun thu nhp c chu k khng phi thng/qu): .
CHI PH HNG THNG:
....................................
Chi ph sinh hot:
...................................
Chi ph cp dng:
...................................
N phi tr hng thng:
...................................
Chi ph khc:
...................................
Mc tch ly cn li hng thng:

...................................

( Mc tch ly = Thu nhp hng thng Chi ph hng thng)

Tng tch ly:

...................................

(Tng tch ly phi quy ra hng thng v c nhiu ngun thu nhp c thi gian khng ng nht)

2.

Lch tr n vay ln ny:


- Lch tr li: .........................................................................................................
- Lch tr vn: .......................................................................................................
- Nhn xt/nh gi v ngun (kh nng) tr n: .................................................

Ch k NVTD/PT:_______________
Mu t trnh c nhn vay tiu dng

Ch k TBP/TP:_______________
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* CHI TIT V NGUN THU NHP T HOT NG SXKD CA KHCH HNG


i. Gii thiu chung v hot ng sn xut kinh doanh

Tn t chc/ tn c s: ....................................................................................................

Tn giao dch: ..................................................................................................................

Loi hnh cng ty: .............................................................................................................

a ch: .............................................................................................................................

in thoi: ........................................................................................................................

S GPKD : .. - ngy cp : .........................................................

M s thu : .... - ngy cp : .........................................................

Vn iu l : .....................................................................................................................

S nhn vin: ....................................................................................................................

Ngnh ngh: .....................................................................................................................

M t hot ng SXKD:

ii.

Mt hng SXKD: ...........................................................................................................

a im SXKD: ............................................................................................................

Din tch c s SXKD: ...................................................................................................

Phng thc SXKD: ......................................................................................................

Ngun u vo: ..............................................................................................................

Ngun u ra: ................................................................................................................

Phng thc thanh ton i vi ngi cung cp v ngi tiu th: ........................

Kt qu kinh doanh v cc s liu ti chnh lin quan n hot ng kinh doanh ca


khch hng: ............................................................................................................

Kt qu hot ng sn xut kinh doanh


Nm:
Nm N

Nm N+1

1. Doanh thu thun

..

2. Gi vn hng bn

..

3. Li nhun gp

..

4. Doanh thu t hot ng ti chnh

..

5. Chi ph hot ng ti chnh

..

Trong : chi ph li vay

..

6. Chi ph bn hng v qun l

..

7. Li nhun t hot ng SXKD

..

8. Li nhun khc

..

9. Tng li nhun trc thu

..

10. Thu thu nhp doanh nghip

..

Ch k NVTD/PT:_______________
Mu t trnh c nhn vay tiu dng

Ch k TBP/TP:_______________
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11. Li nhun sau thu

..

iii. Bng cn i k ton


Nm

Nm N

Nm N+1

Tin v u t ngn hn

..

Cc khon phi thu

..

Hng tn kho

..

Ti sn lu ng khc

..

Ti sn c nh

..

- Nguyn gi

..

- Gi tr hao mn ly k

..

Cc khon u t ti chnh di hn

..

Xy dng c bn d dang

..

Chi ph tr trc di hn

..

..

..

+ N ngn hn (cn vay)

..

+ N trung/di hn n hn phi tr

..

+ Cc khon phi tr

..

N trung/di hn

..

Vn ch s hu

..

..

Tng n vay/Vn ch s hu

......................

.......................

Tng n phi tr/Vn ch s hu

......................

.......................

H s thanh ton hin hnh

......................

.......................

Vng quay vn lu ng

......................

.......................

H s li rng/Vn ch s hu

......................

.......................

H s li rng/Tng ti sn

......................

.......................

Tng ti sn
N ngn hn

Tng ngun vn
iiii. Cc ch s ti chnh c bn

VI. TI SN BO M
1. Phng php nh gi
.
2. M t ti sn m bo
n v tnh:..................
STT

Ti sn m bo
(m t chi tit)

Ch k NVTD/PT:_______________
Mu t trnh c nhn vay tiu dng

Ch s hu

Tr gi thm
nh

S tin cho vay/bo lnh


S tin
% ti tr

Ghi ch

Ch k TBP/TP:_______________
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STT

Ti sn m bo
(m t chi tit)

Ch s hu

Tr gi thm
nh

S tin cho vay/bo lnh

Ghi ch

Tng

3. Tnh cht php l


.
4. Mi quan h gia ch s hu ti sn m bo v bn vay/bo lnh
.
5. Th tc thc hin th chp v qun l ti sn m bo
.
6. Nhn xt:
.
VII. KIN NGH

Trng hp NG CP TN DNG:
Cho vay/cp tn dng: (Tn khch hng kin ngh cho vay/cp tn dng)
+

S tin: (hoc hn mc cp tn dng/hn mc thu chi/hn mc th tn dng/bo lnh):


(bng ch: ...............................................................................)

Mc ch s dng vn :

Thi hn: .. n hn : ................

+ Li sut:
+ Phng thc tr n: Li..... vn ............................................................
+ Ti sn bo m:

Tn TSB 1: ......... thuc s hu ca ............................ Tr gi: ............................

Tn TSB n: ......... thuc s hu ca ............................ Tr gi: ............................

Tng gi tr TSB : ................................................................................................


+ T l mc cp tn dng/TSB: .................................................................................
+ Tng mc tr n/tch ly: .........................................................................................
+ Tng mc tr n/thu nhp: .......................................................................................
+ Tng mc cp tn dng: ...........................................................................................
+ Tng mc cp tn dng ca mt khch hng/nhm khch hng c lin quan:
+ Tng gi tr cc TSB sau khi cp tn dng: ...........................................................
Ch k NVTD/PT:_______________
Mu t trnh c nhn vay tiu dng

Ch k TBP/TP:_______________
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+ T l tng mc cp tn dng/TSB: ........................................................................


iu kin :

Trc gii ngn: ......................................................................................................

Sau gii ngn: ..........................................................................................................

Khc: .......................................................................................................................

Trng hp T CHI CP TN DNG:


+

L do t chi: ..........................................................................................................

NHN VIN QHKH

Ch k NVTD/PT:_______________
Mu t trnh c nhn vay tiu dng

CP KIM SOT

TRNG N V

Ch k TBP/TP:_______________
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