Sales Bill Factoring Application Form

1. General Information:
Business Name Established Registration No.
Address
City State Pin
Ph.: Fax: E -mail:
2. Business Information:        
Type of Business Wholesaler
Legal Structure: Private Ltd. Public Ltd Proprietorship Partnership
Product        
Group Companies: (Please list names and activities of group companies)    
1)        
2)        
3. Sales Information: (Last Financial Year)      
Annual Sales      
Domestic Sales      
Export Sales      
% of credit sales      
Countries Sold: (For export only)      
  Country Standard Terms of Payment Annual Export Sales Volume    
1)    
2)    
3)    
Bad Debt Experience: (Please indicate below net bad debt losses and largest single loss)    
Sales Returns %    
Agents: (Please indicate name and location of agents of your company and their authority)
   
Collection: (Please describe the method used for collecting delayed domestic payments in the past)
   
4. Financial Arrangement:        
Name of the Bank        
Bank Limit        
Branch        
Address        
City State Pin
Contact No Phone    
Collateral: (Please List any assets now assigned, pledged or liened as collateral)
   
5. Required Documents:
  1. Audited Balance Sheet and Profit and Loss Account for the past 3 financial years.
  2. a) A copy of Memorandum and Articles of Association if it is a Public Limited Company
    b) A copy of the Partnership Deed as also the Registration Certificate if applicable.
    c) A brief write up about the company, its shareholding pattern, promoter/s and product details, including quality control measures undertaken.
  3. Sales Literature, sample of invoices and credit notes issued.
  4. Letter of offer from banks for facilities obtained.
  5. Copy of income Tax/ Wealth Tax returns of Directors/Partners.
  6. Four Trade references providing suppliers name, address, contact name and phone number.
6. Application Fee:

A cheque for the application fee of Rs. 25,000/- (made payable to IFCI Factors Limited)
7. Declaration:
We declare that the information given above is correct and we are not aware of any circumstances, which we have not disclosed to you, which might influence your decision. We have no borrowing arrangements other than those mentioned herein; that no legal action has been/is being taken against us; that there are no statuary due; that we shall furnish all other information that may be required by you in connection with our application; that this may also be exchanged by you with any agency you may deem fit; and that you, your representatives/ representatives of your financing banks/institutions. Reserve Bank of India or any other agency as authorized by you, may, at any time, inspect/verify our assets, books of accounts etc. in our factory and business premises.
Buyer Information        
Buyer Name        
Address        
City State Postal Code
Web Site        
Country Contact Person's First Name:  
Contact Person's Last Name: Phone No Fax No
E-mail        
Annual sales to buyer
(Actual for the last 6/12 months) 		   
Annual sales to buyer
(Projected for the next 6/12 months) 		   
No. of Shipments Per year  
No. of Invoices Per year  
Credit Line required on buyer    
Terms of payment offered    
Buyer’s Bank Details:        
Name of Bank Name of Branch  
In addition, please provide the following (for export buyers only):
Annual sales to that country Registration Number of the buyer  
Currency of sale Direct Contact (Allowed or not)  
Attachment: Balance Sheet Company Profile Other Documents
Note:
I. Our correspondents in importing countries will contact overseas buyers before approving credit limits and you may request them to provide required details to them to speed up credit protection process.
II. Realistic credit line in the light of past experience and prospective orders alone may be indicated at the appropriate column above.
(Please feel free to photocopy this page for additional buyers)