6
Equipment Leases (attach separate list if necessary)
Operational Lease:
Financial Lease:
Type: ………………………………………….…
Quantity: …………………………………….….
Make: ……………………………………………
Model number: …………………………….…...
New:
Used:
Year of manufacture: …………………………...
If used, state:
Machine hours:………………..
Location:……………………………….…..……
Equipment cost: ………………………………....
Dealer name………………………………..……
Dealer E-mail……………………………….........
Dealer address (postal and physical address, telephone and fax no)
………………………………………………………………………………………………….……………
…………………………………………………………………………………………………….…………
……………………………………………………………………………………………………………….
Lease term (Please tick one): 6 Months
12 Months
24 Months
36 Months
Have you applied to other institutions for this facilities ? Yes
No
If yes, with whom?..........................................................................................................................................
What have you applied for (guarantee, working articles, asset finance, overdraft)? What is the value of the
facilities applied?..............................................................................................................................................
Have any facility finance applications ever been turn down? Yes
No
If yes, by whom and
why?.................................................................................................................................................................
Have any facility or guarantee issued on your behalf ever been called up? Yes
No
If so, please provide details………………………………………………………………………………..…
What collateral will you pledge: Properties: ………… Vehicle: ………… Office equipment: …………..
Machinery / Plant: ………… Inventory: ………… Other: ……………………………………………....…
Total value of Security provided: N$.................................................
Initial here………………………….