Applicant’s details, assets, debts

and guarantee liabilities

Name of applicant Personal identity code Profession

Assets Value/€
Real estate (location, size, age)

Housing company shares (address, size, age)

Other shares and holdings

Vehicles

Shares of estates

Deposits

Movables (other than ordinary household effects)

Other assets

Total assets

Debts and securities Amount/€

Bank loans

Hire purchase debts

Other debts

Total debts

Guarantee liabilities Amount/€

Guarantee liabilities

I affirm that the information I have provided is correct

Place and date Signature and name in block letters

Finnvera plc Head Office Head Office Telephone Reg. Domicile Business ID
P.O. Box 1010 (Porkkalankatu 1) P.O.Box 1127 (Kallanranta 11) 029 460 11 Kuopio 1484332-4
11.2016 FI-00101 HELSINKI FI-70111 KUOPIO