SME BUSINESS LOAN APPLICATION FORM Level 9, Kina Bank Haus
Douglas Street PO Box 1141
Port Moresby NCD 121
PAPUA NEW GUINEA
SME Unsecured Business Loan SME Secured Business Loan
SME DETAILS
Borrower Name:
Business registration date: Company incorporation number:
Business registration number: TIN
Postal address:
Business locality (section, allotment, suburb details):
Number of employees: Email address:
Business number: Date business commenced:
Contact person and correspondence
Name: Telephone number:
Address:
BORROWING REQUIREMENTS
Purchase inventory/stock K Pay creditors K
Acquire plant/equipment (details): Refinancing of loan (current lender):
K K
Purchase property K Buy another business: K
Other details: K
Further details on purpose of loan (if required):
Total cost: K Source of your contribution? Own cash
Less: contribution by applicant: K Other finance (specify):
Finance required: K Other:
OUTSTANDING LIABILITIES
Monthly
Type of Final Type of security
Outstanding repayment Interest
Name of lender loan/ Credit limit repayment pledged and
balance amount rate %
funding day estimated value
(actual)
K K K
K K K
K K K
K K K
1
SECURITY FOR THIS LOAN (held/proposed)
Type of security offered
a) Mortgage over land, shares/company assets (If land, indicate
whether freehold title or leasehold title) Title in name of owner Estimated market value
b) Guarantees
c) Security over deposits, bill of sale, others
FINANCIAL INFORMATION
Some of the information requested below may not relate or apply to your particular business because of the very nature of the
way the business operates. Note: Do not complete section 1,2,3 if you are enclosing the following documents:
a) Balance sheets with relative explanation notes.
b) Profit and loss accounts.
c) Cash flow projections/budget with relative assumptions.
1. Balance Sheet: latest year ended: (*Interims months to )
Assets Liabilities
Cash/investments K Bank overdraft K
Debtors (trade debtors) K Creditors (trade creditors) K
Stock/wip K Other loans K
Fixed assets K Lease liabilities K
Others K Others K
Total K Total K Surplus Ks
2. Profit and loss account: latest year ended: (*Interims months to )
Revenue Expenses
Sales/income K Depreciation K
Rental income K Interest paid K
Other (i) K Others K
Other (ii) K Total K
Others K
Gross profit K
Net profit before tax K
Tax paid K
Dividend paid K
3. Cash flow projection/budget: from to
Projected sales K
Projected expenses K
Projected operating profit K
2
Please explain assumptions used:
DECLARATION
I/we have read and understood the particulars given in this request and declare them to be true and complete.
The representations have been made to Kina Bank to enable it to determine whether or not to grant a loan to me/us or to
induce Kina to offer me/us a loan.
I/we further hereby consent to release any information held by Kina Bank to a Credit Bureau Agency and also authorise Kina
Bank to enquire with the credit bureau in relation to my credit facility.
This request does not constitute an offer or acceptance of credit.
The representations made by me/us in this request will not constitute part of any contract for a loan that may come into
existence between Kina Bank and me/us. Kina Bank shall be entitled to pass on and to receive any such information to or from
my/our accountant and lawyer and any person authorised to act on behalf of my/our accountant or lawyer.
This authority is not intended to restrict Kina Bank’s ability to give or pass on banker’s opinions;
I/we declare that the loan soaght herein is wholly or predominantly for business purposes and not for personal, domestic or
household purposes.
I/We hereby further irrevocably:
i) Consent to the release of any information held by Kina Bank to a credit bureau agency;
ii) Authorise Kina Bank to enquire with the credit bureau in relation to my/our credit facility;
iii) Authorise Kina Bank to communicate/deal with my/our nominated supplier/dealer/agent/vendor whichever is applicable and
any other entity mentioned in the application form related to my/our loan application; and
iv) Authorise the release of loan proceeds accordingly upon completion of loan documentation to the supplier/dealer/agent/
vendor, whichever is applicable.
Name: Name:
Signature: Date: Signature: Date:
Name: Name:
Signature: Date: Signature: Date:
Shareholders Proprietors Guarantors Directors Chairpersons Mortgagors
3
DOCUMENTS TO BE FORWARDED WITH FORM
Existing Customer
1) Primary supporting documents (please tick if enclosed):
Latest two (2) years financial reports (with explanatory notes);
12 month Cash flow projections/budget (with assumptions);
Updated list of contracts and/or source of revenue;
Financing/loan statement(s) with other institution
2) Other supporting documents
Quotation from Dealer/Supplier;
IRC Annual Tax Returns
New Customer
1) Primary supporting documents (please tick if enclosed):
IPA Certificate of Incorporation
Two (2) types of photo identity of director(s)/guarantors/authorised personnel; (i.e. driving licence, passport);
Company Profile;
Latest two (2) years financial reports (with explanatory notes);
12 month cash flow projections/budget (with assumptions);
List of contracts and/or source of revenue;
Twelve (12) months bank statements;
Financing/loan statement(s) with other institution, and
Land title(s) if applicable
2) Other supporting documents
Quotation from dealer/supplier
Business plans, if any;
Valuation reports (if applicable);
Copy of insurance policy (for property/assets offered as security);
Vehicle registration (if applicable);
IRC Annual Tax Returns
Other*
*If other (please specify):
4
PERSONAL PROFILE FORM Level 9, Kina Bank Haus
(TO SUPPORT SME FINANCE APPLICATION) Douglas Street PO Box 1141
Port Moresby NCD 121
PAPUA NEW GUINEA
PERSONAL DETAILS
Applicants surname: Date of birth:
Applicants given names: Driver licence number:
Postal address: Telephone (Work):
Residential address: Telephone (Home):
Email address 1: Mobile (BMobile):
Email address 2: Mobile (Digicel):
Residential status: Own home Rented home Company provided Other (details):
Occupation: Current employer: Years in current job:
Previous occupation: Previous employer: Years in previous job:
Spouse’s given name: Spouse’s occupation:
Spouse’s employer (if applicable):
Martial status: Married Single Divorced Other Number of dependents:
Experience/qualification: please indicate details of level attained: Tertiary Trade Other
If no formal education attained, please indicate details on number of years in this type of business/industry:
FINANCIAL STATEMENT (MONTHLY INCOME/FIXED COMMITMENTS)
Monthly income (actual figures) Applicant Spouse
Business income/drawings K K
Net rent received K K
Other income (interest/dividends) K K
Other income (salary/wages) K K
Totals K K
Fixed monthly expenses/commitments Applicant Spouse
Mortgage repayments K K
Rent payments K K
Motor vehicle lease/loan repayments K K
Childcare/maintenance payments K K
Other loan repayments K K
Totals K K
Surplus income after fixed expenses/
K K
commitments are deducted
5
STATEMENT OF ASSETS AND LIABILITIES
Note: If ownership of assets and liabilities is shared with another person (e.g. wife, husband, partner, business associate) the
records full name of all interested parties next to related asset/liability. Please round the amounts to the nearest thousand kina.
Fill only were applicable.
Liabilities
a) Mortgage loan lender Interest rate Original term Remaining term Outstanding balance K Kina use only
b) Other mortgage lender Interest rate Original term Remaining term Outstanding balance K
c) Overdraft lender Interest rate Original term Outstanding balance K
d) Personal loan lender Interest rate Original term Remaining term Outstanding balance K
e) Lease liability lender Interest rate Original term Remaining term Outstanding balance K
Credit card type Issuer Outstanding balance K Kina use only
Other liabilities owing to name of parties
(i) (ii) (iii) Outstanding balance K Kina use only
Taxation owed Year ending Outstanding balance K Kina use only
Other liabilities details Outstanding balance K Kina use only
Kina use only
Total liabilities
Assets
a) Real estate property address Registered owner Estimate of value K Kina use only
b) Real estate property address Registered owner Estimate of value K
c) Superannuation/life policy name of company Registered owner Estimate of value K
d) Bank accounts (including term deposit accounts)
(i) Bank Type Number Estimate of value K Kina use only
(ii) Bank Type Number Estimate of value K
(iii) Bank Type Number Estimate of value K
6
e) Motor vehicles
Make Year made Make Year made Estimate of value Kina use only
f) Furniture and other personal effects (list major items)
(i) (ii) (iii) Estimate of value K Kina use only
Other assets details Estimate of value K Kina use only
Kina use only
Total assets
DECLARATION
We have read and understood the particulars, which have been completed in this form and declare that and represent that
these particulars are true and complete in every particular. I/we acknowledge that the representations made by me/us in this
form have been made to Kina Bank to enable it determine whether or not to grant a loan to me/us. I/we hereby authorise Kina
Bank to make any other enquiries relative to this enquiry, which it considers necessary and for that purpose from any bank,
details of my/our account. We also understand that this form does not constitute an offer or acceptance of credit in terms of
any act or ordinance relating to the provision of credit. The representations made by me/us in this form do not and will not
constitute part of any contract for a loan that maybe subsequently come into existence between Kina Bank and me/us. We
acknowledge that I/we have made the representations constituted by completing this form in order to induce Kina Bank to offer
to grant me/us a loan. I/we further hereby concent to release any information held by Kina Bank to a Credit Bureau Agency and
also authorise Kina Bank to enquire with the credit bureau in relation to my credit facility. I/We hereby further irrevocably:
i) Consent to the release of any information held by Kina Bank to a credit bureau agency;
ii) Authorise Kina Bank to enquire with the credit bureau in relation to my/our credit facility;
iii) Authorise Kina Bank to communicate/deal with my/our nominated supplier/dealer/agent/vendor whichever is applicable and
any other entity mentioned in the application form related to my/our loan application; and
iv) Authorise the release of loan proceeds accordingly upon completion of loan documentation to the supplier/dealer/agent/
vendor, whichever is applicable.
Name: Name:
Signature: Date: Signature: Date:
