(TO BE FILLED CAPITAL LETTER/TYPE) INQUIRY FORM: CIB 1A For Individual/Institution

Tick New Renewal Enhancement Others

Amount of Loan Applied for: In Figure. In Words. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Name of the Bank/ Financial Institution Name of Branch: Under district of Reference Nos. of branch Reference Nos. of Head Office Borrower code (If available) Name of the borrower in full Abbreviated name (in case of individual) Fathers name (in case of individual) Mothers name (in case of individual) Husbands name (in case of individual) Address a) Permanent b) Present c) Business d) Factory Tel. Nos. TIN National Identity Number : THE HONGKONG & SHANGHAI BANKING CORPORATION LTD. : DHAKA : DHAKA Branch Code No: 19-0002 : Date: : Date: : : : : : : : : : : : : : :

13. 14. 15.

To the best of our knowledge the above borrower obtained the credit facilities from different banks/ financial institutions as mentioned below: Name of the Banks/ financial Institutions Name of branch with district I. II. Signature: Head of the Branch/ Manager Name: Safayat Hasan Seal: Tel: 9660536 Note: Suppressing or distortion of any information (related to borrower/ owner) by bank/ financial institution is punishable under Bangladesh Bank Order 1972, Chapter IV Art.48.

Undertaking

(TO BE FILLED CAPITAL LETTER/TYPE) Annexure-A

To, The Manager HSBC Sub: Submission of information about the ownership of the borrower enterprise/ about the individual borrower.

Dear Sir, I, _______________________________________________(Full Name) Owner of ___________________ Fathers Name (Full Name):_______________________________________________________________ Mothers Name (Full Name):______________________________________________________________ Husbands Name (In case of married women): ________________________________________________ Permanent Address: _____________________________________________________________________ Business Address: _______________________________________________________________________ National Identity Number: TIN Tel. Nos. :_______________________________________________________________________ :_______________________________________________________________________

am applying in my own name/in the name of the organization under my ownership for sanction of loan/renewal of loan/rescheduling of loan. I enclose the list of organization maintained in my own name/under my ownership/under my management and my interest involved in addition to the one mentioned above. If any organization other than the ones mentioned below is found in my own name/under my ownership/management, I shall be legally liable for giving false statement. The authority shall have the power to take any legal action against me for suppressing facts and I shall remain legally bound to accept the decision of the authority.
Serial No. Name of the Organization Permanent Address Business Address Whether the Company is presently enjoying any credit facility or not Yes Name of the Lending Bank/ Financial Institution

No
Branch Name

I shall be bound to inform the authority any changes in the above information within 2 (Two) weeks of such change. In case of failure the authority can take appropriate legal action against me.

Certifying Bank Officers Signature, Name, & Seal (With Date): Signature;

Name; Name & Seal Organization:

of

the

Borrowing

Date:

The Manager HSBC Motijheel Branch Dhaka

Dear Sir, Subject: Debit Authority for Obtaining CIB report. Pls be informed that, I am going to apply for a loan from your esteem Bank. Prior to applying I am requesting to deduct BDT100 from my account no for obtaining CIB report from Bangladesh Bank.

Thanking You

A/C Name: A/C Number: