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    Adia Application Form

    Uploaded by

    chebetdamaris50
    application

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Adia Application Form

    Uploaded by

    chebetdamaris50
    1 views5 pages
    application

    Original Title

    ADIA_APPLICATION_FORM

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    application

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    1 views5 pages

    Adia Application Form

    Uploaded by

    chebetdamaris50
    application

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 5

    ABU DHABI INVESTMENT AUTHORITY

    211 Corniche, PO Box 3600


    UNITED ARAB EMIRATES

    PROJECT FUNDING APPLICATION FORM

    SECTION A – Loan Applicant Details

    1) Applicant
    name(s):

    2) Company
    name:

    3) Company address:

    4) Business Tel (b)Mobile number

    5) E-mail address:

    6) Business type (please tick as appropriate)


    (a)Sole Trade (b) Partnership
    (c) Limited Company (d) Family owned (e) other

    7) Date business established

    8) : Company Registered Number

    9) Accounting year end:

    10) Brief description of business:


    Complete section (11) If the other share Holders are involved

    11) Shareholders - Names of shareholders and shares owned:


    (a)Name:
    Shares/Equity Held:

    (b) Name:
    Shares/Equity Held:

    (c) Others:

    SECTION B – General information about the loan request

    1) Why are you applying for the loan? (Give a brief description ofthe
    project/purpose of the loan

    2) Total cost of project

    3) Loan amount requested

    4) Over what period? (Maximum


    10years)

    5) Do you wish to repay by monthly or quarterly installments?

    6) Do you require a capital repayment holiday? Yes/No


    If so for how long? (Maximum 12
    months)

    7) What are the detailed project costs?


    $
    $

    Total cost of project (A)


    $
    $
    Total of non ADIA funding (C) if any$

    5) What are the sources of the non ADIA funding?


    Bank loan/overdraft

    Grants

    HP/leasing

    Your personal finances

    Total of non ADIA funding (C)


    $

    SECTION C – Financial Results


    1) Historic Accounts – Last 3 Years *
    Year Ending

    2021
    $

    2022
    $

    2023
    $

    * SECTION D – Bank Account Details.


    Bank name:

    Bank Address:
    Swift Code:

    Sort Code:

    Account Number:

    Name of Account Holder:

    SECTION E – General

    1) Has any owner, partner or director of the business


    a) Been convicted of fraud or any other offence involvingdishonesty?
    Yes/No
    b) Had judgment entered against you in the county court?Yes/No
    c) Had judgment entered against you in the county court? Yes/No
    If the answer to any of the above is YES please give details below:
    d) Been adjudged bankrupt or subject or a personal voluntary creditors
    Arrangement? Yes/ No

    I/We do not intend to delay or defraud any creditors, or engage in any illegal conduct in
    relation to creditors and do not intend to engage the services in order to facilitate or
    otherwise engage in such activity.

    I/We hereby expressly, specifically and unqualifiedly agree to wholly hold harmless and
    indemnify, officers, directors, employees, agents and nominee shareholders and (or)
    nominee directors provided by you. Or its agents if any, from any liabilities of any kind or
    character arising out of any lawful actions taken by them in reliance upon any fact or
    statement contained in this declaration which may hereafter prove to be untrue or materially
    inaccurate

    I/We wish to apply for a loan from Abu Dhabi Investment Authority as detailed on this
    application form and I/we confirm that the information on this Application Form is correct to
    the best of our knowledge and belief and agree that ADIA may make any further enquiries
    regarding this application.

    Signature of Applicant:

    Date: / / / /
    FOR OFFICE USE ONLY

    Verification officer: Mr Khalifa Farook

    Position: Head of re-evaluation/Strategic Department (For Abu Dhabi


    Investment Authority)

    Date: / / / /

    Official Seal:

    Loan Application Approval code

    © 2024 ADIA. All Rights Reserved.

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