Tp. H Ch Minh, ngy .. thng ..

nm
HCMC, ..
GIY NGH VAY VN NGN HN
APPLICATION FOR SHORT TERM LOAN
(p dng cho khch hng doanh nghip- For corporate)
Knh gi:
To:

NGN HNG INDOVINA- HI S

INDOVINA BANK- HEAD OFFICE

I. GII THIU KHCH HNG - APPLICANTS INFORMATION

- Tn cng ty: .
Company name:..
- a ch:.
Address:.
- in thoi: S fax: ..
Tel:
Fax: .
- Giy KKD s: Cp ngy:.. Ni cp:
Registration No:.. Date of issuane:.. Issued by:..
- Ngi i din:.. Chc v:
Represetative:.. Position:.
II. NHU CU VAY VN- LOAN REQUEST
S vn vay:
Loan amount:..
Mc ch:...
Purpose:
.
Thi hn:
Loan term:
Li sut:.
Lending rate:
III. K HOCH S DNG VN VAY- LOAN UTILIZING PLAN
Phng n s dng vn (Loan utilizing plan)
Nhu cu vn:. Vn t c:.. Vay IVB:..
Total demand: Own capital:
From IVB:
..
Hiu qu s dng vn (Loan utilizing efficiency)
Doanh thu (Turnover)
..
Gi vn hng bn (Cost of goods sold)
..
Li gp (Gross income)
..
Chi ph hot ng (Operating expenses)
..
Chi ph li vay (Interest expenses)
..
Li nhun (Net income)
..
K hoch tr n (Repayment plan)
..
Ngun tr n (Repayment sources)
..
Phng thc tr n (Mode of repayment) ..
IV. TI SN M BO- COLLATERAL
Loi ti sn:

Bt
ng sn
Type of collateral
Real estate
1/2

h xng
Plant

N
Thit
b my mc
Machinery equipment

Khc
Others

Tr gi:.
Value:.
a ch:
Address:.
V. TNH HNH TI CHNH- FINANCIAL HIGHLIGHTS
Doanh thu
.
Revenue
..
Khon phi thu
..
Receivable
..
Khon phi tr
..
Payable
..
Hng tn kho
..
Inventory

VI. QUAN H NGN HNG- BANKING RELATIONS

D n vay ngn hn

Ngy o hn:.
Short term loan outstanding
.. Maturity date:..
Ti ngn hng
. .
With bank:
...
Ti sn m bo
. .
Collateral
..
Tr gi:
. .
Value
.. ..
D n vay trung di hn

Ngy o hn:
Midium long term loan outstanding
.
Maturity date:.
Ti ngn hng
.
With bank:
..
Ti sn m bo
. ..
Collateral:
..
Tr gi:
. .
Value:

..

S d bo lnh:
. Ngy o hn:
Guarantee Outstanding:
.. Maturity:.
Ti sn m bo:

.
Collateral:
..
Tr gi:
. .
Value:

Ti/chng ti cam kt:

I/we hereby certify to:
- Chp hnh y cc quy nh hin hnh v quy ch cho vay ca ngn hng Nh nc v Ngn hng
Indovina.
Follow all the current regulations of The State Bank of Vietnam and Indovina Bank strictly.
- Chu trch nhim v tnh chnh xc, hp php ca cc ti liu cung cp cho Ngn hng Indovina.
Be responsible for the accuracy and illigality of the information provided for Indovina Bank.
CNG TY/THE APPLICANT

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