Loan to Other Banks .........YES (...).........NO (...)

If Yes:

By which Bank.....................__________________

Amount..............................__________________

Actual Outstanding...............__________________

Out of it Overdue.................__________________

Source of Information........Shareholders (...).......Menagement Staff (...)

about Credins....................Building........(...).......Ocassion.............(...)

........................................Others.........(...)

Borrower's Signature

____________________

________________________________________________________________________

( to be filled out by Credins )

Comments:

________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________

Reasons of Rejection ( if request rejected )

________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________

Signature of Credins person in charge

____________________

________________________________________________________________________

Note: You can get a printable version of this application by downloading the file below:

application.xls