• Home

Purchase Order Finance

Purchase Order Finance

Application Form

Company Details
Company Name
Field is required!
Incorporation Number
Field is required!
Nature of Business
Field is required!
Date of Incorporation
Field is required!
Vat No.
Field is required!
Postal Address
Field is required!
Physical Address
Field is required!
Previous Physical Address
Field is required!
Business Contact Person
Field is required!
Tel - Work (+267..)
Field is required!
Tel - Mobile (+267..)
Field is required!
Tel - Home (+267..)
Field is required!
Company Email Address
Valid email address required!
Company Bank Details
Bank Name
Field is required!
Branch Name
Field is required!
Account Name
Field is required!
Account Type
Field is required!
Branch Code
Field is required!
Account No.
Field is required!
Ownership and Management

Please provide the following details for each shareholder of the company.


Shareholder's name
Field is required!
National ID Number
Field is required!
  • Nationality
  • Afghanistan
  • Albania
  • Algeria
  • Andorra
  • Angola
  • Antigua and Barbuda
  • Argentina
  • Armenia
  • Australia
  • Austria
  • Azerbaijan
  • Bahamas
  • Bahrain
  • Bangladesh
  • Barbados
  • Belarus
  • Belgium
  • Belize
  • Benin
  • Bhutan
  • Bolivia (Plurinational State of)
  • Bosnia and Herzegovina
  • Botswana
  • Brazil
  • Brunei Darussalam
  • Bulgaria
  • Burkina Faso
  • Burundi
  • Cabo Verde
  • Cambodia
  • Cameroon
  • Canada
  • Central African Republic
  • Chad
  • Chile
  • China
  • Colombia
  • Comoros
  • Congo
  • Cook Islands
  • Costa Rica
  • Croatia
  • Cuba
  • Cyprus
  • Czechia
  • Côte d\\\\\\\\\\\\\\\'Ivoire
  • Democratic People\\\\\\\\\\\\\\\'s Republic of Korea
  • Democratic Republic of the Congo
  • Denmark
  • Djibouti
  • Dominica
  • Dominican Republic
  • Ecuador
  • Egypt
  • El Salvador
  • Equatorial Guinea
  • Eritrea
  • Estonia
  • Eswatini
  • Ethiopia
  • Faroe Islands
  • Fiji
  • Finland
  • France
  • Gabon
  • Gambia
  • Georgia
  • Germany
  • Ghana
  • Greece
  • Grenada
  • Guatemala
  • Guinea
  • Guinea-Bissau
  • Guyana
  • Haiti
  • Honduras
  • Hungary
  • Iceland
  • India
  • Indonesia
  • Iran (Islamic Republic of)
  • Iraq
  • Ireland
  • Israel
  • Italy
  • Jamaica
  • Japan
  • Jordan
  • Kazakhstan
  • Kenya
  • Kiribati
  • Kuwait
  • Kyrgyzstan
  • Lao People\\\\\\\\\\\\\\\'s Democratic Republic
  • Latvia
  • Lebanon
  • Lesotho
  • Liberia
  • Libya
  • Lithuania
  • Luxembourg
  • Madagascar
  • Malawi
  • Malaysia
  • Maldives
  • Mali
  • Malta
  • Marshall Islands
  • Mauritania
  • Mauritius
  • Mexico
  • Micronesia (Federated States of)
  • Monaco
  • Mongolia
  • Montenegro
  • Morocco
  • Mozambique
  • Myanmar
  • Namibia
  • Nauru
  • Nepal
  • Netherlands
  • New Zealand
  • Nicaragua
  • Niger
  • Nigeria
  • Niue
  • North Macedonia
  • Norway
  • Oman
  • Pakistan
  • Palau
  • Panama
  • Papua New Guinea
  • Paraguay
  • Peru
  • Philippines
  • Poland
  • Portugal
  • Qatar
  • Republic of Korea
  • Republic of Moldova
  • Romania
  • Russian Federation
  • Rwanda
  • Saint Kitts and Nevis
  • Saint Lucia
  • Saint Vincent and the Grenadines
  • Samoa
  • San Marino
  • Sao Tome and Principe
  • Saudi Arabia
  • Senegal
  • Serbia
  • Seychelles
  • Sierra Leone
  • Singapore
  • Slovakia
  • Slovenia
  • Solomon Islands
  • Somalia
  • South Africa
  • South Sudan
  • Spain
  • Sri Lanka
  • Sudan
  • Suriname
  • Sweden
  • Switzerland
  • Syrian Arab Republic
  • Tajikistan
  • Thailand
  • Timor-Leste
  • Togo
  • Tokelau
  • Tonga
  • Trinidad and Tobago
  • Tunisia
  • Turkey
  • Turkmenistan
  • Tuvalu
  • Uganda
  • Ukraine
  • United Arab Emirates
  • United Kingdom of Great Britain and Northern Ireland
  • United Republic of Tanzania
  • United States of America
  • Uruguay
  • Uzbekistan
  • Vanuatu
  • Venezuela (Bolivarian Republic of)
  • Viet Nam
  • Yemen
  • Zambia
  • Zimbabwe
Nationality
Field is required!
DOB
Field is required!
Position
Field is required!
Phone Number (+267..)
Field is required!
Shareholding %
Field is required!
Tender Issuer Details
Order/Principal Issuer
Field is required!
Tel - Office (+267..)
Field is required!
E-mail Address
Valid email address required!
Fax
Field is required!
  • - select issuer type -
  • Central/Local Government
  • Parastatal
  • Corporate
  • Private Company
- select issuer type -
Field is required!
Manufacturer / Supplier Details
Manufacturer/Supplier Name
Field is required!
Postal Address
Field is required!
Physical Address
Field is required!
Tel - Office (+267..)
Field is required!
E-mail Address
Valid email address required!
Fax
Field is required!
Manufacturer Bank Details
Bank Name
Field is required!
Branch Name
Field is required!
Account Name
Field is required!
Account Type
Field is required!
Branch Code
Field is required!
Account No.
Field is required!
Transaction Details
Contract Value
Field is required!
Total Amount Required
Field is required!
Proposed Repayment
Field is required!
What is the purpose of the loan?
Field is required!
Declaration
l / we hereby declare that the information above is, to best of my/our knowledge and believe, true and correct. I / we further declare that the money shall be used solely for the purpose indicated above and that there is no legal impediment for the intended use.
Signature (authorised representative)
Field is required!