Online Loan Application

Borrower data

Company *

UIC *

Owners/Shareholders

Name *

% share *

Contact information

Contact person *

Position *

E-Mail *

Phone *

Preferred office *

Information about the requested loan

Loan amount *

Loan term (in months) *

Purpose of the loan *

The loan is intended for *

Collaterals

Collateral type *

Short description *

Expected price *

Total collaterals value

Financial Information

Total amount of current loans *

	2022	2023
Earnings before tax *
Depreciation expenses *
Depreciation expenses *
Net income *
Earnings before interest, taxes, depreciation and amortization in

Currently do you have overdue loan or other liabilities?

Yes

Overdue payments text

I agree to the verification of the filled information in the Central Credit Register at BNB

By submitting the completed information, I agree to the processing of my personal data from Tokuda Bank.

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