Youth Fund Form – Fill Out and Use This PDF

Current Location (draw map):		Legal Structure of the Business( copy of		Premises
		certificates/articles to be attached)		Rent	
Address:		Sole Trader		Own	
		Partnership		Other	
Telephone :		Limited	
		Other	
Duration at this location?		Landlord Name:
		Telephone Number :
Do you intend to relocate?	Yes  No 	Number of Paid Employees
If yes, why?		Full-time _______ Casual ________

Other Businesses owned by Applicant/ Spouse

Location of Businesses:

SAVINGS/CURRENT ACCOUNT HISTORY

Bank/Institution ___________________________ Account No:______________________Account Balance___________

Bank/Institution ______________________________ Account No:_________________________ Account Balance___________

(Please provide copies of 6 months certified statements)

REFERENCES: Name, Address and Telephone *

List three or more references, Address & Tel.No. (suppliers, Landlords, peers, etc)
Name	Telephone	relationship

1.

2.

3.

CREDIT HISTORY (Prior 3-5 years)

Have you ever applied for a loan before? Yes () No (). If yes, please provide details below:

Name of Lender

Date Applied

Amount of Loan

Duration of Loan

Monthly Instalment

Amount outstanding

______

______

___

______

_________________

______

______

_______

______

___

______

______

_______

______

___

____________________

_

______

______________

______

___

Do you plan on borrowing any money from;

Creditors

NGOs

Banks

Family members

Other(specify)

If yes, please provide terms and purpose.

_____

____________

BUSINESS ASSESSMENT

Major Business Suppliers: (See receipts)

Major Business Markets: (See records/sales books)

Where do you buy? Who do you buy from?

Where do you sell and who do you sell to?

How often do you buy?

How long does it typically take to sell your purchases/

inventory?

How much do you buy each time?

How much do you sell in a typical week? month?

Will this change as a result of the loan? If Yes, how?

Will this change as a result of the loan? If so, how?

GROSS PROFIT MARGIN ON BEST SELLING PRODUCTS
Product	Selling Price (A)	Purchase Price/Cost of	Gross Profit Margin
		Production (B)	( A-B) / A
1.
2.
3.
4.
Average
Average Projected on Previous Loan Application

PROPOSED GUARANTORS

Name, address and telephone number/other contact information:					Relationship:
1.		______	_____	______	____________________________
2.				______	____________________________

Do any of the proposed guarantors have existing direct/indirect liabilities with the YEDFB? If Yes, what?

SECURITY/COLLATERAL

Kindly list all the Securities, giving a detailed description and Serial Numbers where Applicable. Where holder of security is not an applicant, one of the guarantors must be the holder of security.

DESCRIPTION OF ITEM	SERIAL NUMBER	VALUE(KSH)

TOTAL LIQUIDATION VALUE

Other significant personal assets owned not listed as collateral and any liabilities against them:____________

I/We declare that all information provided as part of this application conforms to reality and assume full responsibility for its accuracy. By my signature, I hereby authorise collection of references, from any source whatsoever, concerning my person, conduct and commercial credit. I further authorise the issuance of reports regarding my credit history to Youth Enterprise Development Fund Board and hereby absolve the reporting party of all responsibility.

1st Applicant’s Name ____________________Signature________________________ Date___________________

Co-Borrower’s Name____________________Signature________________________Date___________________

2nd Applicant’s Name ____________________Signature________________________ Date___________________

Co-Borrower’s Name_____________________Signature________________________Date___________________

YOUTH ENTERPRISE DEVELOPMENT FUND BOARD

GUARANTOR PERSONAL DETAILS

Guarantor Name: ___________ ____________ ___________

ID/PP No_________________

Relationship to Applicant: _______________________________________

Postal Address: ___________ Code: ___________ Phone No: _____________

Residence (draw map):

Town/Estate:___________________ District___________________________________

Division: ________________________ Location: _______________________________

Sub-Location: _____________________ Village: _______________________________

Employment or business: ___________________________________________________

Physical Location: ________________________________________________________

Monthly Income: __________________________________

Attachable Security (Title deed, log book etc) where guarantor is providing security for the loan

No	Description	Serial No.	Estimated	Discounted
			Value	Value
1
2
3
4
5
6
7

Signature of Guarantor __________________________Date: ____________________