SUPPLEMENTARY INFORMATION FOR THE LEASE LIMIT APPLICATION

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1 SUPPLEMENTARY INFORMATION FOR THE LEASE LIMIT APPLICATION 1. Applicant s data Company s name (address, phone) NIP (VAT) and REGON numbers Contact person 2. PPROPERTIES HELD Address Type of property Property Register no. ha Market value Total mortgage encumbrans 3. Company s business activities: Share of the range of goods in sales Sale of farming machinery [%] share in revenue 4. Capital/ organisational/ personal relations within Group of Companies: Company s name and address Type of relation [%] of shares Equity in [PLN k] 5. Number of persons employed: Sale structure: DOMESTIC: % EXPORT: % 7. Major customers Company s name/ country Individual customers Products [%] share in sales Terms of payment [days] How long has been the cooperation? [years] 1

2 8. Major suppliers: Name Products [%] share in purchases Terms of payment How long has been the cooperation? [years] 9. Major competitors and company s market position (strengths/weaknesses): 10. Existing credits and loans as of... Lender Credit / loan type Credit given Current debt Maturity date 11. Existing leases (expt IKB Leasing Polska Sp. z o.o.) as of... Lessor Leased assets Current debt Lease expiration 12. Reivables structure (paid on time/ overdue) as of... Total Current items up to 30 days items days Including overdue items over 90 days 2

3 13. Liabilities structure (paid on time/ overdue) as of... Total Current items up to 30 days Including overdue items days items over 90 days 14. For any loss occurred in the last full or current accounting period, specify the reasons Statement: I hereby represent that we have/have not any due liabilities to the Social Insuran Institution [ZUS] or Inland Revenue and we are/are not a party to any arrangements for payment of such liabilities to any of these two bodies. 16. I apply for a limit of EUR/PLN for the following objects: 17. Attachments: a b Balan Sheet and Income Statement for last two years and up-to-date Shareholder s PIT tax returns for last two years Yes No d mation on assets and liabilities expt those relating to the business conducted, plus signed data base consents (for each Shareholder) e *where applicable date, signed 3

4 Information on assets and liabilities expt those relating to the business conducted Full name Address, phone Pesel ID no. Marital status (separation of property) Company s name (address, phone) SHARES IN OTHER ENTITIES Entity s name and address Number of shares Nominal value Estimated current total market value REAL PROPERTY Address Type of property Property Register no. Date of purchase Market value Total mortgage encumbrans Other property (machines, devis, movable property above PLN 100 k) Type Estimated market value Encumbrans Reivables (e.g. loans extended) Debtor s name and address Type of reivables Total amount of reivables Due date Collateral 4

5 Loans/ credits/ leases/ warranties, guarantees given Lender s name and address Type of liability Total liability Maturity date Collateral Court, enforment, composition, bankruptcy, restructuring proedings - personal or relating to businesses conducted Total liability Type of proeding Main creditors covered by the proeding Term Guarding Equipment statement is true and correct. Pla, date Signed by the person making the statement 5

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SUPPLEMENTARY INFORMATION FOR THE LEASE LIMIT APPLICATION

SUPPLEMENTARY INFORMATION FOR THE LEASE LIMIT APPLICATION 1. Applicant s data Company s name (address, phone) NIP (VAT) and REGON numbers Contact person 2. PPROPERTIES HELD Address Type of property Property