Small Entrepreneurship Form

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To:
Director of the Hub (name of the hub) of Fund for Support of Small
Entrepreneurship “FORA” (name of the director)
From: ___________________________________________________________
______________________________________________________
__________
home
address:_______________________________________________
_____
______________________________________________________
__________
Certificate# ________________ as of
________________________________
TIN___________________________________________________
_________
LOAN APPLICATION FORM
I request a loan in the amount of ____________________________( ________________________ ) roubles for
__________________________________________________________________________________________
(loan purpose)
for a period of _______ months, and I ask to transfer these funds to my personal/settlement
account
(cross
out
what
is
unnecessary)
in
the
bank
(name
of
the
bank)
________________________________________________
settlement account (personal account)
___________________________________________________________
correspondent account _______________________________________________________________________
BIK
_____________________________________________________________________________
_________
TIN (of the bank)
____________________________________________________________________________
Date of application: «____» __________________ 200___
I have been acquainted with the terms of the loan and agree with these terms:
Applicant
_____________________
(signature)
/_________________________________/
LOAN MANAGER RECOMMENDATION
I recommend to issue a loan in the amount of ____________________ roubles at the rate of _____% per annum for
__________________months; the loan repayment schedule ______________________________________
the loan collateral provided by the borrower or other persons (check what is necessary) :
Joint guarantee of a group of ____ members
Guarantee of ________natural persons
Guarantee of ________legal persons
Pledge of the following property ____________________________________________________________
_______________________________________________________________________________________
provided by the borrower or a third party.
Loan Manager ________________________/_____________________/
«_____»_______________200_ .
Verification of the accounting department: previous loan was fully repaid in accordance with loan repayment
schedule, or other ________________________________________________________________________
Chief accountant: ______________ (signature) /____________________________/ (name)

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