BOND RAISE FACILITATION PRE-EVALUATION FORM SL.NO.

(HO)
Date

S.NO DETAILS (Value in USD) REMARKS

1 NAME & ADDRESS OF THE COMPANY

2 PUBLIC / PRIVATE

3 COUNTRY

4 COMPANY WEBSITE

5 FUNDING REQUIREMENT(BOND VALUE)

6 NATURE OF BOND (CORPORATE/MUNICIPAL BOND)

PROJECT DETAILS*(if Corporate Bond) Please provide:

a. Debt Equity Ratio
b. Capital Gearing Ratio
c. EBITDA(Earnings Before Interest,Taxes,Depreciation and
7
Amortization)
d. IRR(Internal Rate of Return)
e.Cost of Capital(if available)
f. Pay Back period

8 PROMOTER'S STAKE ( VALUE OR %)*

IN CASH / IN KIND*
9 (Promoter's cash contribution or contribution in terms of
Assets revlevant for this project)
PRE-HISTORY OF BONDS ISSUED* (IF ANY)
10

ONGOING OR PENDING LEGAL ISSUES BY THE

11 COMPANY/PROMOTERS* (IF
ANY)

a. NAME OF THE BANK

b. CURRENT BANKING LIMITS (IF ANY)
12 c. FULL PARTICULARS OF THE BANK
d. BANK OFFICER CONTACT DETAILS

13 SOVEREIGN RATING OF THE CLIENT'S COUNTRY

BILATERAL RELATION OF THE BOND ISSUING COUNTRY WITH

USA (POSITIVE LIST/NEGATIVE LIST)
14
If negative, whether any economic sanction imposed on the
applicant country?

15 BOND TO BE RAISED IN USA YES / NO (delete accordingly)

HAS THE COMPANY BEEN RECENTLY RATED BY A REPUTED

16 YES / NO (delete accordingly)
RATING AGENCY

17 IF YES, WHAT IS THE RATING

INDEPENDENT LEGAL ADVICE ON ELEGIBILITY AND

18 YES / NO (delete accordingly)
CONFORMITY WITH APPLICABLE REGULATIONS OBTAINED

19 NAME OF THE BANKING REGULATOR IN CLIENT'S COUNTRY

20 ANY OTHER INFORMATION TO BE SHARED

* REQUIRES SUPPORTING DOCUMENTS

We declare that the information furnished above is true and correct to the best of our knowledge and we are aware that we will be solely responsible for any
discrepancy, if found subsequently.
We hereby confirm EEB's engagement as a facilitator to raise funds on our behalf through Bonds in USA/…........ Markets as per the apprised/ approved norms and
directives.

Please sign below:

Name
___________________________________ Place _______________________ Date _________________

Note: Please fill the required details and forward the completed form and relevant supporting documents to bonds@euroeximbank-sales.com

To be filled by the Sales Person

Customer Sales Person Name

Name
Customer Sales Person Contact number
Contact
Number
Customer Sales Person Email id
Emaild id