CLIENT REGISTRATION FORM 2018

Please Complete all required field (*)
  1.Personal Details  
 
Title:* Surname:* Names:*
 
Gender:  DOB:  Nationality: 
Male Female
 
ID:  Email:  Telephone: 
 
Marital Status:  Cellphone:
Single Married Divorced Widowed
 
 
  2. Employement Details
 
  Occupation:
 
  Types of Employement (Tick)  
Contract
Pensioner Private Practice Self-Employment
Student Unemployed  
 
 
  3.Current Residential Address
 
Physical Address Postal Address Chief
 
Indvuna Qualifications Attachments
 
  4. Business Details
  
Give a brief description of the business  
 
Business Sector Do you have a business plan or business proposal ?  
New Business   Existing Business Attach Business Plan:
 
In a case of an existing business provide cash flow projections for past twelve months
Cash flow
  
  5. Type of the Business:  
 
Sole Trader Partnership Company  

Number of employees

Location of business

Age of business

How would you like to be financed?

Loan Equity Mezzanine

Loan/Equity/Mezzanine (combination of laon and equity)amount rquired

(E)

In the case of loan, how long would it take to recover the loan

(Payback period)

Other Requirements for the business

 

Income generated by the business (A twelve month projection)

E

Value of Net Assets (E)

 

List of Assets (provide documentation to prove ownership)

Present Value of liabilities E

List of Liabilities

Detail the main capital expenditure

Briefly give an outlook of the business (management plans, business performance in the future)

Letter of Intent: 
Copy of Orders: 
Copy of Tenders: 
Copy of Contracts: 
ID Copies of director's:

CV of key personnel(s):
Trading license copy: 
Lease of property: 
 
Please indicate you have the following documents by Ticking the appropriate:)  
Copy of identities of director's
CV of key personnel Trading license copy Ownership of operating premises/lease of property
NIDCS agent who assisted you  

Advice from NIDCS agent regarding the business plan/proposal

 

 

Declaration
I (surname and name(s)) Customer name declare that the information in this application form is complete and true and that I have not withheld no information whatsoever that may tend in any way to increase the Corporation’s risk or influence their decision regarding this application and I further undertake to exercise all reasonable precautions for the safety of the business plan proposed. I agree that this declaration shall be the basis of the contract between me and National Industrial Development Corporation of Swaziland (NIDCS). The Financing doesn’t commence until acceptance has been confirmed by the Financier.
I Agree