Escolar Documentos
Profissional Documentos
Cultura Documentos
Phone: Phone:
Do you intend to relocate? Yes No Do your children attend school? Yes No
If so, why?
Number Attending Schools?
Any positions of leadership within the community
Number of Dependants:
Spouse Name Spouse ID NO. Phone
Phone: Phone:
Do you intend to relocate? Yes No Do your children attend school? Yes No
If so, why?
Number Attending Schools?
Any positions of leadership within the community
BUSINESS DETAILS
Business Name: Description of Business Activity/Products No. of Years in
Operation
Reg. No.......................................................
Licence No..................................................
Directors:
1.
2.
3.
YEDF/CRE/04/001A/2014 FORM 001 A
Current Business Location (Market): Legal Structure of the Business( copy of
certificates/articles to be attached) Premises
Town: Sole Trader Rent
Partnership Own
Address: Limited Other Other
Telephone :
Duration at this location? Landlord Name:
Telephone Number :
Do you intend to relocate? Yes No Number of Paid Employees
If yes, why? Full-time _______ Casual ________
Draw a map showing direction to the business on the space provided below:
2.
3.
____________
YEDF/CRE/04/001A/2014 FORM 001 A
BUSINESS ASSESSMENT
Major Business Suppliers: (See receipts) Major Business Markets: (See records/sales books)
Where do you buy? Who do you buy from? Where do you sell and who do you sell to?
Gross Profit
Gross Profit
Rent Rent
Transportation Transportation
Labour Labour
Other Other
Stock
CAPITAL
TOTAL TOTAL
YEDF/CRE/04/001A/2014 FORM 001 A
NET HOUSEHOLD BUDGET
Pensions Food
SECURITY/COLLATERAL
Kindly list all the Securities, giving a detailed description and Serial Numbers where Applicable. Where holder of
security is not an applicant, one of the guarantors must be the holder of security.
Other significant personal assets owned not listed as collateral and any liabilities against them:____________
DESCRIPTION OF ITEM SERIAL NUMBER VALUE(KSH)
YEDF/CRE/04/001A/2014 FORM 001 A
a) In connection with this application and/or maintaining a credit facility with the Youth Enterprise Development
Fund, I/We authorize the Youth Enterprise Development Fund to carry out credit checks with or obtain
my/our credit information from, a credit reference bureau. In the event of the account going into default, I/We
consent to my/our name(s), transaction and default details being forwarded to a credit reference bureau for
listing. I/We acknowledge that this information may be used by banking institutions and other credit grantors in
assessing applications for credit by me/us, associated companies, and supplementary account holders and for
occasional debt tracing and fraud prevention purposes.
b) I/We agree that the Youth Enterprise Development Fund may disclose details relating to my/our loan account
to any third party including credit reference bureaus, if in the Lenders opinion such disclosure is necessary for
the purposes of evaluating my/our creditworthiness or any transaction with or credit application made to the
Lender or such third party, maintaining my/our Account with the Lender or for any other lawful purpose.
c) I/We agree that the Lender may disclose details relating to my/our loan account including details of my/our
default in servicing financial obligations on my/our loan account to any third party including credit reference
bureaus for the purpose of evaluating my/our credit worthiness or for any other lawful purpose
d) I/We declare that all information provided as part of this application conforms to reality and assume full
responsibility for its accuracy.
e) By my signature, I/We hereby authorise collection of references, from any source whatsoever, concerning
my/our person, conduct and commercial credit.
f) I further authorise the issuance of reports regarding my credit history to Youth Enterprise Development Fund
Board and hereby absolve the reporting party of all responsibility.
(Spouses)
Co-Borrowers Name____________________Signature________________________Date___________________
Co-Borrowers Name_____________________Signature________________________Date___________________
Co-Borrowers Name_____________________Signature________________________Date___________________
YEDF/CRE/04/001A/2014 FORM 001 A
Town/Estate:___________________ District___________________________________
Attachable copy of Security (Title deed, log book etc) where guarantor is providing security for the loan
No Description Serial No. Estimated Discounted
Value Value
1
2
3
4
5
6
7
Town/Estate:___________________ District___________________________________
Attachable copy of Security (Title deed, log book etc) where guarantor is providing security for the loan
No Description Serial No. Estimated Discounted
Value Value
1
2
3
4
5
6
7