1. How Did You Hear About Us?(*)
---Search EngineBrokerWebsiteRecommendationOther
2. Please state the name of broker, website or source you heard about us from.

3. I/ we confirm having read the FAQ section (FREQUENTLY ASKED QUESTIONS) of this website:(*)
YesNo
4. FULL NAME (*)

5. ARE YOU A: (*)
RepresentativeBrokerIntermediary
6. APPLICANT’S FULL NAME : Completing this application form.(Must be the developer/ borrower)(*)

7. DEVELOPER CURRENT PROFESSION/ STATUS:(*)

DEVELOPER CORRESPONDENCE ADDRESS:
1. Office telephone:

2. Cell phone:(*)

3. Fax:

4. E–mail:(*)

5. Website:

HAS THE DEVELOPER/BORROWER:
1. Approved the contents of this Project Finance Application Form?(*)
YesNo
2. Received a copy of this completed Project Finance Application Form?(*)
YesNo
3. Is this the first time you are seeking financing for this project?(*)
YesNo
4. If “NO”, when did you start seeking finance for your project?

5. DESCRIBE YOUR PROJECT: (For which you are seeking finance).(*)
Theme ParkWater ParkMallStadiumFECMarinaAttractionsHotelResortCasinoOther

DESCRIBE THE COMPANY SEEKING FINANCE:
(It’s legal status, only if formed already)
(Corporation, LLC, Partnership, Inc., Limited Company, Sole Proprietor, other):
1. NAME OF PROJECT (if chosen already)(*)

2. Legal Location of Company Registration

3. Company Registration No. ( if any )

4. Date Company Established

5. Location where Company was registered

6. CURRENT OWNERS and / or SHAREHOLDERS: (at the time of application):

7. COMPANY BOARD OF DIRECTORS AND OFFICERS NAMES (at the time of application):

PROJECT DESCRIPTION: Please describe it in details
1. Available land area:( specify measurements in square meters,acres or hectares)(*)

2. Is land zoned for your loan purposes?(*)
YesNo
If “Yes”, state current type of zoning:

3. PROJECT SITE LOCATION AND ADDRESS:(*)

4. THE NEAREST INTERNATIONAL AIRPORT TO THE SITE:(*)

Describe in your own words (the current stage of project development), by ticking one or more of the following:
1. Start-up construction, no works done:(*)
YesNo
2. Some other works done (studies/ research/other)(*)
YesNo
3. Is a written land survey available?(*)
YesNo
4. Date of survey?

DETAILED WORKS ALREADY COMPLETED: (where applicable)
1. Marketing Feasibility Study (MFS)(*)
YesNo
2. Financial Feasibility Study (FFS)(*)
YesNo
3. Business Plan (BP)(*)
YesNo
4. Development Budget (DB)(*)
YesNo
5. Initial Outline Architectural Master Plan (IOAM)(*)
YesNo
6. Final Architectural Master Plan (FAM)(*)
YesNo
7. Environmental Impact Study (EIS)(*)
YesNo
8. Social Impact Assessment (SIA)(*)
YesNo
9. Full Information Technology Survey (ITS)(*)
YesNo
10. Biological and Environmental Assessment (BEA)(*)
YesNo
11. OTHER TESTS COMPLETED?(*)
YesNo
12. Water(*)
YesNo
13. Soil(*)
YesNo
14. Rock Bed(*)
YesNo
15. Quantity survey obtained completed?(*)
YesNo
16. Construction estimate completed?(*)
YesNo
17. Planning applications has already been submitted?(*)
YesNo

Building application submission date (if applicable):
1. Has the land already been acquired? (*)
YesNo
If “Yes”, at what value?

2. State month / year of acquisition

3. If “No”, has a deposit secured the land site?
YesNo
4. How much deposit has been paid?

FINANCIAL INFORMATION ( NAIRA equivalent ) NOTE: amounts in (a), (b) and (c) must total that in (d).
a) How much of ''a'' above, has been provided by the Shareholders as equity / partnership / joint venture?(*)

b) How much additional equity are you seeking? (future additional partners)(*)

c) How much total loan capital are you seeking? (financing only)(*)

d) TOTAL ESTIMATED PROJECT COSTS: (*)

1. Are you contemplating using all / part of any future loans for any payments other than for your project?(*)
YesNo
2. LOAN PERIODS Please state your preferred loan period, (excluding existing and or additional equity requirements)(*)
Less than 5 yearsMore than 10 yearsIn excess of 15 yearsAs long as possible

GUARANTEES/ LITIGATION (Although not required in most cases, we need to know shareholders’ personal willingness to issue personal guarantees).
1. Are you willing to provide personal guarantees?(*)
YesNo
2. Are there any outstanding litigation matters against the company, and / or its owners / officers? (*)
YesNo
If “Yes”, please describe:

DUE DILIGENCE
1. Are your shareholders prepared to submit to a due diligence investigation / procedure?(*)
YesNo
2. Is there any information about the Shareholders / Investors / Directors / Project, which you do not wish to disclose in the future?(*)
YesNo
3. Are you prepared to disclose to us all sources which have been approached in the past for equity/ loans, for this project?(*)
YesNo
4. Have you any objections to a number of brokers / sources being involved in locating finance?(*)
YesNo