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FINANCIAL PRE-SCREENING SUMMARY FORM
[Best method is to take help of your Accountant / CPA to prepare the documents]
Section one
1.
Name of Project:
2.
Contact information for the Corporation or Ownership Group:
(a)Name:
(b)Address:
(c)Telephone:
(d)Fax:
(e)Email:
3.
Contact information of Registered Agent for the Corporation or Ownership Group:
(a)Name:
(b)Address:
(c)Telephone:
(d)Fax:
(e)Email:
4.
Patriot Act information:
(a)Citizen of (state the country):
(b)Social Security/National Identification Number:
(May use EIN of Company)
(c)Company Registration number:
(d)Place, State and date issued:
(e)Attach copy of registration:
5.
The Applicant is:
(a)Govt. Corporation / Public Ltd Co./ Pvt Ltd / Trust
/ Partnership Group:
(b)Individual:
6.
The sum required is $
(USD).
7.
The advanced sum will be used to: (Explain)
8.
Describe Your Asset/Project:
9.
Do you propose to develop and hold the Asset/Project as an
investment or is it proposed to develop for sale upon completion?
(Explain length to complete Project and exit strategies)
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