APPLICATION
FOR A LOAN
Aplikacja
do wypelnienia i wyslania
$10 Million
to $1 Billion USD Loans
Our primary
source for funding can provide (through some of the
largest Canadian and American banks and lenders)
private equity capital. We prefer U.S., Canada,
Australia, Europe, Caribbean and GCC based
projects but can go into other international arenas
($50 million minimum) on a project by project basis. We
can help with funding on the following project
types: Acquisitions, Construction
Financing, marinas, Subway extensions, Historic
Buildings Restoration projects, Condo and Town Home
Developments, Care Facility, Corporate Expansion,
Energy Projects, Factories, Films,
Full Service Major Flagged Hotels, Golf Courses,
Growth Capital, Hospitals,
International Financing, Joint Ventures, Land
Loans, Leasing Programs, Manufacturing Plants,
Marinas, City Planning, Medical Offices, Mergers,
Mining, Mixed Use, Housing and Resort Developments,
Multifamily Condos, Gas and Oil, Office Buildings,
Oil and Gas, Parking Structures, Permanent
Financing, Project Financing, Residential
Development, Golf Resorts, Shopping
Centers, Startups, Expressways, Bridges, Machinery,
Production Lines, Airports,
Theme Parks, Warehouses, etc.
PRINT THIS FORM, PROVIDE ALL INFORMATION AND MAIL
IT to arch. J. J. Gruzewski
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In addition to the
completed application, please enclose documentation that
might affect the consideration of this
application.
We seek a foreign currency loan in
the amount of (in USD):
.....................................................................
(in words):
....................................................................................................................................................................
for the
financing
of:
................................................................................................................................................................
................................................................................................................................................................
.................................................................................................................................................................
located in:
......................................................................................................................................
(please include existing
documentation or a detailed description of the planned
investment)
INFORMATION
ABOUT APPLICANT
1. Company
name____________________________________________________________________
Address
_________________________________________________________________________
Telephone (_______)
_____________________________ fax (________)
____________________
E-mail:
...................................................................................................
Web site:
...................................................................................................................................................
2. Company management
______________________________________________________________
_________________________________________________________________________________
3. Date company was
founded
__________________________________________________________
4. Legal status
(form of
ownership) ___________________________________________________________
a/ Registration Number
_______________________
b/ Tax Number
________________________
5. Organizational
structure and activities
_________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
6. Gross sales of last
three years: 2001: ___________ $, 2002:_______________ $,
2003: ______________ $
7. Profits of last three
years: 2001:___________ $, 2002:_______________ $, 2003:
_____________ $
8. Company assets:
...............................................................................................................................
(total amount,
including the value of all investments, inventory, fixed
assets, receivables, and bank accounts: estimate if
necessary)
Total a) in Local
currency ______________________ b) in dollars
______________________
9. Total number of
employees
__________________________________________________________
10. Total area of land
facilities (m
2 ) _______________________________________________________
11. Total area of
building facilities (m
2 ) ____________________________________________________
12. Numbers of Land
Registry /KW
no____________________________________________________
of the Registry
Office_______________________________________________________________
for the land to be used
in the project as well as other real estate
properties.
PROJECT
INFORMATION
1. Project type
(construction
/ modernization / development)______________________________________________
_________________________________________________________________________________
2. Degree of document
preparation:
a) Financial 1.
Opportunity study (OS)
__________________________________________
2. Pre-feasibility study
(PS) _________________________________________
3. Feasibility study (FS)
____________________________________________
b) Technical Project
conceptualization
__________________________________________
2.
Technical-technological preliminary study
_____________________________
3. Finalized
documentation
__________________________________________
3. Companies that
prepared the documentation (company
name and address)
.......................................................................................................................................................................
a) financial
documentation (pre-feasibility and feasibility study)
_____________________________
b) finalized,
technical-technological, and structural
______________________________________
4. Legal and zoning
arrangements with state and local authorities
(specify
any requirements which might hinder
project
realization)
_________________________________________________________________________________
_________________________________________________________________________________
5. Opinion of local
authorities, i.e. environmental protection agency,
land-water management agency
_________________________________________________________________________________
_________________________________________________________________________________
6. Expected time-frame
for project realization
Proposed date of
commencement
_________________________________________________
Proposed date of
completion
______________________________________________________
Proposed date of start-up
_________________________________________________________
Attainment of full
production capacity
______________________________________________
7. Proposed time-frame
for loan disbursement
from-to
(day-month-year)
amount
(in
USD)
__________________________
__________________________
____________________________
__________________________
8. Total cost of the
project (Exchange
rate at time of analysis 1 USD =__________________Local
currency _____________
Total expenses
____________________Local currency _________________mln
USD
Construction /
installation ____________________Local currency
_________________mln USD
Cost of equipment
____________________Local currency _________________mln
USD
Other expenses
____________________Local currency _________________mln
USD
Total imports
____________________Local currency _________________mln
USD
Amount of credit
needed _____________________mln USD
9. Please specify the
value of own resources (cash) set aside for the project
______________mln USD
and in land ,materials,
equipment, labor, etc. _____________________ mln
USD
Repayment schedule
________________________________
Grace period
_____________________________________
monthly
. quarterly
. semi-annually
.
11. Sources of financing
for the project
domestic own
___________________ Local currency ___________________ mln
USD
___________________ Local
currency ___________________ mln USD
___________________ Local
currency ___________________ mln USD
___________________ Local
currency ___________________ mln USD
___________________ Local
currency ___________________ mln USD
___________________ Local
currency ___________________ mln USD
___________________ Local
currency ___________________ mln USD
___________________ Local
currency ___________________ mln USD
___________________
Local currency __________________ mln USD
Credit will be used for
the following goods and services
(product or
service, purchase price, seller name and
country)
_________________________________________________________________________________
_________________________________________________________________________________
PROPOSED
COLLATERAL
(terms of
collateral will be individually negotiated with the
borrower)
1. Outside guarantees
_________________________________________________________________
2. Mortgages
_______________________________________________________________________
3. Government guarantees
____________________________________________________________
4. Cessions
________________________________________________________________________
5. Bank guarantees
__________________________________________________________________
6. Promissory notes
__________________________________________________________________
7. Other forms of
collateral
____________________________________________________________
DECLARATION
OF OUTSTANDING DEBTS
We declare that at the
present time our firm has the following obligations to these
foreign and domestic
entities:
(provide
complete name of creditor along with address, amount of
debt, and relationship of such obligations to
proposed
project)
____________________________________________________________________________________
____________________________________________________________________________________
JOINT
VENTURE (U.S. & CANADIAN COMPANIES)
INFORMATION
Regardless of financing,
if you are interested in an American partner for the
creation of a joint venture,
please answer the
following:
1. Reasons for forming
joint venture partnership
trade purchases ˜
new facilities ˜ marketing ˜
market access ˜
licenses ˜ technology transfer ˜
turn-key investments
˜ subcontracting ˜ equipment provision
˜
loans / capital ˜
management ˜ technical assistance ˜
expansion / ˜
training ˜ other ˜modernization
2. Activities to be
engaged in by joint venture (joint
trade, production, etc.) ______________________________
________________________________________________________________________________
________________________________________________________________________________
3. Please list all other
expectations from an American or Canadian joint-venture
partner (profile
of proposed
partner,
subcontractor, transfer of licensed technology,
export-import. etc.) ________________________________________________
____________________________________________________________________________________
TRADE
INFORMATION
1. What products (other
than those listed as part of investment procurement) are you
interested in
purchasing from the
U.S.A. or other Western countries:
___________________________________
_______________________________________________________________________________
a) In what quantities:
(per month)
_____________________________________________________
2. What products are you
interested in selling:
_____________________________________________
________________________________________________________________________________
b) In what quantities:
(per month)
_____________________________________________________
Please
mail completed and signed application form to:
PROSZE
WYPELNIC, DOLACZYC OPLATE I WYSLAC NA ADRES:
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Arch. Jerry J.
Gruzewski, PO Box 120380 - Dubai, UAE
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Include
processing fee of $750 and $150
payable to: JAROSLAW J. GRUZEWSKI,
quoting the Project’s name on both checks.
If the project is not accepted by us, and
processing fee included, documentation and $250
will be sent back to the applicant.
Use International Money Order, International,
Business, Personal or American Express checks,
Western Union or a wire transfer (our account will
be provided).
APPLICATIONS
WITHOUT PROCESSING FEES WILL NOT BE TAKEN UNDER
CONSIDERATION
Phone:
+1 (617) xxxxx E-mail: ddmcuae@aol.com
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First and Last Name:
.....................................................................................................................................
Company:
......................................................................................................................................................
Position:
........................................................................................................................................................
Telephone:
........... (___________)________________________ country:
..........................................................
Fax:
.....................
(___________)_________________________
E-mail:
................................................................................................
Mobile:
...............................................................................................
IMPORTANT
: All above
information is treated as confidential. Providing misleading
information will immediately disqualify your application.
Applications received without the required fee will
not be processed, applicants will not be
notified and applications will not be
returned.
______________________________________________
........................................................................
Signature of applicant
Date / Company seal or stamp /
form:
013/USC/JJGruzewski
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