Background Information

“TAILOR-MADE CREDIT PROGRAMME”
* Required Information.
	Date:

GENERAL INFORMACIÓN:
*Name of person or entity:	*ID No. or VAT:

# Tel 1.	# Tel 2.

# Tel 3.	# Tel 4.

*Email:	City:

Province:	Country:

Address:


INFORMATION OF THE ORGANIZATION, ASSOCIATION OR LEGAL ENTITY:
Activity:	Years:

No. of employees
MEN WOMEN
Anual Revenues (US$ or ¢):	Legal representative (if applies):


CONDICIONES DEL CR€DITO:
Amount (US$ or ¢):	Type of credit product
	Financing for Investments:
	Line of Credit:
	Second-tier Banking
Conditions (if applies):Period:	Grace period:

Others:

Detail of the invesment or use of the credit:


WARRANTY:
Type of :
Pledges Mortgages Guarantee trust	Approximate Value (US$ or ¢):
Description:

*I certify that all information provided is true and authorize Fundecooperación for it verification:
Name:	ID number:

Important:

The information provided is essential for the first contact with the possible beneficiary.

* To complete the application process to the “Tailor-made Credit programme” must complete the following forms.

“TAILOR-MADE CREDIT PROGRAMME”