Cim Finance Ltd.

P.O. Box 297, Manhattan Building,

c/r Edith Cavell & Mère Barthélemy Streets, Port Louis, Mauritius
Tel: + 230 203 6800 Fax: +230 203 6816
Email: finance@cim.mu www.cimfinance.mu
Business Reg. No.: C06001288
VAT Reg. No.: VAT20009016

Cim MoCrédit Application

Customer Status: Existing ■ New Date: ______________ Application No: _____________________

1. PERSONAL DETAILS

Family Name Residential Address

First Name

NIC/Passport

Date of Birth (DD/MM/YY) Time at Residential Address (Years)

Marital Status Permanent Address (Years)

(Time at permanent address)
Email Postcode

Mobile Home telephone

Residential Status Rented ■ Fully Owned Living with Relatives Mortgaged Others (Specify)

2. MY EMPLOYMENT DETAILS

Details Salaried ■ Self-employed Sales/Commission-based Others (Specify)

Office Telephone

Employer’s Name/Trade Name

CMCA 02-06, Issue No. 01

Employer’s Address/Business Address

Industry Sector

Job Title/Nature of Business

Time in current employment ............ year(s);If less than one year please provide details of your previous employment

Previous Employer Time in previous Job (Years)

3. CREDIT DETAILS
Purpose of Credit Facility ...................................................................................... CPAL Ref (Office use)

Credit Amount Interest rate (% p.a)

Repayment Term (Months) Processing Fee (%)

Monthly Installment Payment Mode Standing Order ■ Bank Transfer Cheque Cash

4. COLLATERAL (AMOUNT > RS 500K)

Unsecured Secured ■
Asset Type Asset Details Estimated Value (Rs)

5. INSURANCE (Life cover)

Be Safe Cover - Cim Agencies
■ Life Cover from another company (Specify)

6. MY FINANCIAL SITUATION
*Income (MUR) Expenses (MUR)

Monthly Yearly Remaining Repayment term (Loans) Monthly Yearly

Basic Salary Loans/Leases
Overtime & Commissions Credit Card
Other Allowances (For e.g. Car, Fuel, etc) Average Household Expenses
Other income Utilities
Total Total

*Income should be able to be verified through bank statements, payslips, tax returns or business financials.

Page 1 of 3
 7. BANK ACCOUNT DETAILS
Name of Account Holder Bank
Account Number to be debited Branch
Savings ■ Current O/D Limit

8. DECLARATIONS
By providing my signature herein, I accept the offer of the credit facilities provided by Cim Finance Ltd as set forth in this application form, together with the
respective terms and conditions and/or agreement (as may be amended) that shall follow the application form.

I understand that Cim Finance Ltd reserves the right to reject the application at its sole discretion.

I ............................................................................................................., the undersigned declare that I exercise my free choice as to the insurance policy
required to guarantee the credit facility granted to me.

I confirm that the information given above is true, correct and complete and I understand that the credit facility, if approved, will be governed by the Laws of Mauritis.

Full Name ..................................................................................................................

Signature .............................................................

Date: ..................................................

9. GUARANTOR
I ................................................................................................................................................., accept to bind myself and act as guarantor for
Mr/Mrs/Miss ................................................................................................. with respect to the credit facilities provided by Cim Finance Ltd
as detailed in this application form. I, confirm that the information provided above is true, correct and complete and I understand that the credit facility,
if approved, will be governed by the Laws of Mauritius.

Family Name Residential Address

CMCA 02-06, Issue No. 01

First Name

National ID Card
Postcode
Date of Birth (DD/MM/YY)
Mobile
Marital Status
Office telephone
Email
Home telephone

Residential Status Rented ■ Fully Owned Living with Relatives Mortgaged Company Provided
Details Salaried ■ Self-employed Sales/Commission-based Others (Specify)

Employer’s Name

Employer’s Address

Industry Sector

Job Title

Time in current employment ............ year(s);If less than one year please provide details of your previous employment

Previous Employer Time in previous Job year(s)

Signature of Guarantor ............................................................................

10. SIGNATURE

‘I/We, the undersigned, hereby confirm that the information given above is true, correct and complete and I/we understand that the requested credit
facility, if approved, Cim Finance Ltd may request all information on my/our credit status from the Mauritius Credit Information Bureau. I/We understand
that Cim Finance Ltd reserves the right to reject any application at its sole discretion and without having to state any reason.’

Client’s signature Date

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 For Office Use Only

COMPLETENESS DOCUMENTS

Standing order (Bank evidence and signature/ thumbprint) Applicant NIC/ Passport

Credit Facility Agreement including Terms and

Proof of Address - (as disclosed above)
Conditions to the Agreement (Signature of client)

Be Safe and/or any Credit Insurance Plan (CIP) Latest pay slip

Bank Statements (Last six months)

Tax returns and /or business financials

Cim Finance Employee

Application Processed by

Date Submitted

Time Submitted

Approved by

Time
CMCA 02-06, Issue No. 01

Date Approved

Committee Date

By signing this Application Form electronically, you acknowledge that your electronic signature is as valid and enforceable as your handwritten signature
and is binding and effective to the terms and conditions set forth in this Application Form. You further consent that your electronic signature alone, without
any verification or certification from any third party is sufficient to justify the legitimacy of your consent to this Application Form, in its entirety. This Application
Form may be executed in any number of counterparts and delivered by means of facsimile transmission or via e-mail by an authorised person or otherwise,
and each of which when so executed and delivered shall be deemed to be an original and all of which when taken together shall constitute one and the
same Application Form.

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 SUPPLEMENT TO CIM MOCRÉDIT APPLICATION FORM
(Applicable exclusively for Cim MiStudy)
This Supplement shall form an integral part of the Cim MoCrédit Application Form. Terms used on this Supplement will, unless otherwise defined herein,
have the same meaning and construction ascribed to them in the Cim MoCrédit Application Form.

By applying for Cim MiStudy herein and signing the Cim MoCrédit Application Form , the client hereby agrees to provide the specific details required
in this Supplement.

Part I : Application details - Cim MiStudy Only

a. Accredited University Details*

Name of University/Institution

Address of University/Institution

Course Type Diploma ■ Undergraduate Postgraduate

ACCA CFA Other (Please specify)............................

Course Name

Course Duration (Years)

Study Mode Full-time Part-time Distance Learning ■

*A
 ny credit facility application for a particular Course at a particular University/Institution will be subject to credit
assessment and such University/Institution shall be accredited by TEC or any other relevant authority.

b. Course Fees *
SCMCA 02-06, Issue No. 01

Full Course Fees (MUR)

Fees payable per academic year (MUR)

*Credit Amount will be subject to credit eligibility criteria

c. Student Details (if different from borrower)

Relationship with Applicant N/A Please specify ………………………………..................................……………….

Family Name

First Name

NIC/Passport

Date of Birth (DD/MM/YY)

Marital Status

Email

Residential Address

Mobile

Home telephone

*By providing your e-mail address and/or mobile phone number, you consent to receive electronic communication from CIM FINANCE LTD or any
other party acting on its behalf.

If you want to receive communication by SMS and/or e-mail from CIM FINANCE LTD, please tick this box. By providing your
signature herein, you accept the offer of the facilities offered by CIM FINANCE LTD as set forth in this application form, altogether
with the respective terms and conditions and/or agreement (as may be amended) that shall follow the application form.

In the event that the application for a credit facility under Cim MiStudy is approved, the application will be subject to the Terms and Conditions of the
Cim MoCrédit credit facility agreement and any other special Terms and Conditions, as may be applicable.

[Supplement] Page 1 of 2
 Part II : OPTION CREDIT CARD*

Would you like a CREDIT CARD? Yes ■ No

If YES, which card would you like to have ?

What CREDIT LIMIT you would like to have? MUR

*An application form should be filled separately for a credit card.

For Office Use Only

OTHER DOCUMENTS

Student details * Course details

Student NIC/PASSPORT Letter of Offer from University or institution

Student Birth Certificate and/or such evidence to establish relationship Proof of cost and duration of studies (as applicable)

Other related documents Other related documents

*In cases where the borrower is not the student

SCMCA 02-06, Issue No. 01

[Supplement] Page 2 of 2