Form DFC-001 Application for Debt Financing

Application for Debt Financing (DFC-001)
OMB No. [
]
Expiration Date: _______

United States International Development Finance Corporation
1100 New York Avenue, NW Washington, DC 20527-0001
An Agency of the United States Government

Responses to questions which call for estimates or projections should take the form of good
faith statements made to the best of the applicant’s knowledge and belief. Statements of fact
provided in this document must be accurate as of the date of submission. Anyone who
knowingly makes a false statement with the intent to influence DFC’s guarantees, loans, or
other investments may be criminally prosecuted. Such false statements are also grounds for
DFC to terminate a commitment or declare a contract default. These rights are in addition to
any other rights or remedies available to the United States government. Neither submission
nor acceptance of this application implies that the proposed transaction is eligible for support
or that support will be provided.
When trade secrets or confidential commercial or financial information are submitted to the
agency in this collection, they will be held in confidence to the extent permitted by applicable
law including the Freedom of Information Act (“FOIA”) at 5 U.S.C. § 552(b)(4) and the
agency’s implementing regulations at 22 C.F.R. Part 706.
Paperwork Reduction Act Notice: This information is required to obtain or retain benefits.
Federal agencies may not collect information unless a valid OMB Control Number with an
expiration date that has not expired is displayed. The public reporting burden for this collection
of information is estimated to average 90 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. Send comments
regarding this burden estimate or any other aspects of this collection of information, including
suggestions for reducing this burden, to Agency Clearance Officer, Records Management,
United States International Development Corporation, 1100 New York Ave.,
NW, Washington, DC, 20527 and to the DFC Desk Officer at the Office of Information
and Regulatory Affairs, Office of Management and Budget, New Executive Office Building,
Room 10202, Washington, DC 20503.

This Form and any attached supporting documentation will enable DFC personnel to make a
preliminary determination of whether your proposal meets eligibility and basic underwriting
requirements. Please click here to review the basic eligibility requirements. For a description of DFC’s
Debt Finance origination process and answers to frequently asked questions (FAQs), please click
here. For general questions or eligibility questions, please email [email address of new DFC domain
to be added]. If a particular question on this form is unclear, please email [email address of new DFC
forms domain to be added].
QUESTION 1: SPECIFY FINANCING STRUCTURE
The DFC supports a wide variety of developmental transactions by providing direct loans and
guaranties. Though each transaction may have unique structural aspects, all transactions fit into one
of four basic structural categories. Please read the definitions below and choose the structure that
best fits the type of support that you are seeking.


Project Finance: DFC lends to a stand-alone project or single purpose entity. Click here for
examples.



Corporate Finance: DFC lends to a general corporate entity that already has an operational
track record. Click here for examples.
Single-Borrower Guaranty: Outside funding party intends to provide financing to a single
borrower. DFC will share the funding party’s risk by providing a guaranty. Click here for
examples.
Multi-Borrower Guaranty: Outside funding party intends to provide financing to multiple
unrelated borrowers. DFC will share the funding party’s risk by providing a guaranty of the
sub-transactions on an individual or portfolio basis, as the case may be. Click here for
examples.




QUESTION 2: IDENTIFY THE PROPOSED BORROWER/GUARANTEED PARTY
In each DFC-supported transaction, DFC enters into a contractual relationship with either a Borrower
(in the case of Project Finance or Corporate Finance transactions) or a Guaranteed Party (in the case
of Single or Multi-Borrower Guaranties). Please list the location and contact information for that party.
If that party has not yet been formed/incorporated, please list approximate information that will allow
us to create a placeholder for that party in our transaction tracking systems.
Borrower/Guaranteed Party
Name:
Address (incl. city and country):

website (if avail):
DUNS Number:
U.S. Tax Identification Number:
or
N/A – Not a US Taxpayer
Is the country listed in the address of the Borrower/Guaranteed Party the location where the funds
provided or guaranteed by DFC will be utilized? (Yes/No)
If “No,” please list the actual location (city, country):
[Sub-question if the Financing Structure chosen in Question 1 is “Single Borrower Guaranty”:
Please provide the name and address of the entity to which the Guaranteed Party will be lending]

Commented [HD(1]: Note for applicant: This information is
not required at initial submission of the form. If DFC decides to
support the requested transaction, then the applicant will be required
to obtain/provide a DUNS number prior to execution of the
transaction.

QUESTION 3: IDENTIFY THE APPLICANT REPRESENTATIVE
Please provide contact information for the individual who will be DFC’s primary point of contact
regarding this application.
Name and Title of Representative:
Relationship to the Borrower/Guaranteed Party: (Change this to a drop-down box)
Name of Representative’s Company (if different from the Borrower/Guaranteed Party)
Address:
Phone Number 1 (office):
Phone Number 2 (mobile):
E-mail:
QUESTION 4: IDENTIFY THE KEY PARTIES INVOLVED WITH THE TRANSACTION
Evaluating the business entities and/or individuals that will own, manage or make other critical
contributions to the transaction being financed is an important part of DFC’s underwriting process.
Please attach detailed chart(s)/schematic(s) showing the structure of the proposed transaction and
key relationships. These may include ownership charts, organizational/management structures,
contractual relationship schematics, etc. Please click here for examples.
[Mandatory “Attach” button]
Please list and provide requested information on each of the following types of entities/individuals. If
an entity/individual plays multiple roles in a transaction, only list them once and indicate their most
important/primary role:
•
•
•
•

Each business entity/individual that owns 10% or more (either directly or indirectly) of the
Borrower/transaction.
Each business entity/individual that does or intends to provide credit support (e.g. a guarantor)
Each business entity/individual that does or will have a significant managerial relationship with
the Borrower/transaction (e.g. executives/directors).
Each business entity/individual that does or will have a primary contractual relationship with
the Borrower (e.g. construction contractor, operations and maintenance contractor, hotel
management company, etc.)

Note: Certain governmental/multilateral parties that may be involved and shown in the attached charts
need not be listed here. Please click here for a definition of such parties.
Name
Type of Entity
Country of Citizenship (for Individuals)
or Incorporation (for Business Entities)
Primary Relationship to
Borrower/Transaction
Minority Owned or Led?
Women Owned or Led?
If yes, please provide:
% owned by women
# of women on Board of Directors

Two choices: Individual or Business Entity
Choices – Owner/Shareholder, Manager/Director, Contractor
Y/N
Y/N
%
#

Commented [HD(2]: (a) the World Bank, regional development
banks, multilateral and bilateral development institutions and their
affiliates;
(b) the United Nations or agencies thereof; and
(c) U.S. federal, state, regional or municipal governments, or any
departments, agencies or instrumentalities thereof.
Commented [HD(3]: For U.S. entities, at least 51% of the
owners or members of the board of directors are African Americans,
Hispanic Americans, Native Americans, Asian Pacific Americans
and Subcontinent Asian Americans.
For non-U.S. entities, at least 51% of the owners or members of the
board of directors are members of a demographic/social group
considered to be a minority and/or economically disadvantaged in
the country where the entity is incorporated/operates.
Commented [HD(4]: A “women-owned enterprise” is one in
which women own at least fifty one percent (51%) of the company,
or where the company was founded by a woman who continues to
play an active role in running the company. A “women-led
enterprise” is one in which the share of women in senior
management is at least 30% or women comprise 30% or more of the
board, investment committee or equivalent governing and/or
investment decision-making bodies.

names and titles of women owners and Text box
executives:
Is this Party interested in DFC PRI?

Commented [HD(5]: DFC offers Political Risk Insurance that
covers a variety of political risks, including political violence,
expropriation and currency inconvertibility. Please check this box to
indicate if this party would like to learn more about DFC’s political
risk insurance program and availability of coverage for this project.

QUESTION 5: DESCRIBE THE TRANSACTION
Please provide a brief description of the proposed transaction, making sure to address the following:
•
•
•

What are the objectives – commercial-financial and/or social-developmental – of the proposed
transaction?
What factors or resources under the control of the involved parties will contribute most toward
meeting those objectives and why?
How would DFC’s participation in the transaction contribute to its success?

Please attach the following supporting documents:
Business Plan/Preliminary Information Memorandum
[click here for guidance]
Financial Projections Model [click here for template and
user guides]
Historical Financial Statements [click here for guidance]
QUESTION 6:

[Insert required button for attachment]
[Insert required button for attachment]
[Insert required button for attachment]

DETAIL COSTS AND FUNDING

[If the Financing Structure chosen in Question 1 was Project Finance, then the online form will show
the following:]
For a Project Finance transaction, please provide a detailed list of the estimated project costs and the
types and amounts of funding that will be used to cover them. Remember to include both hard/physical
asset costs (e.g. buildings or equipment) and soft/implementation costs (e.g. legal or consultant
services, fees, contingency etc.) in the cost estimate. The total cost amount in Column A must equal
the total funding amount in Column B. For an example, please click [here].

Cost Item

Column A
USD

%

Funding Source
Debt:
DFC loan (indicate proposed term)
Other term debt (indicate proposed term)
Supplier financing

Column B
USD

%

Subordinated Debt:
Third party subordinated debt
Shareholder subordinated loans

Total Project Costs:

Equity:
Cash
In-kind contribution 1
Grants
Other (please describe)
Total Project Funding

1
An in-kind contribution could be a hard asset such as a building, land or equipment. In order for DFC to credit it as an
equity contribution, it must be titled to the Borrower, and DFC must receive reasonable documentation of its market value
(e.g. a recent appraisal, sales invoice, etc.)

[If the Financing Structure chosen in Question 1 was Corporate Finance, then the online form will show
the following:]
For a Corporate Finance transaction, please provide a detailed list of how the DFC-supported funding
would be used and how the proposed transaction would affect the existing corporate funding
structure/leverage of the Borrower. For an example, please click [here].
Uses of the DFC-supported Funding
Cost Item

USD

%

Total Costs
Balance Sheet Comparison
Existing Balance Sheet

USD

%

Total Assets
Total Debt/Liabilities
Net Worth

Proposed Future Balance
Sheet
Total Assets
DFC Debt
Non-DFC Debt/Liabilities
Net Worth

USD

%

Would DFC debt be used to repay any existing debt? Yes/No
If yes, please describe the source and current terms of the debt that would be repaid and why the
repayment is important to the overall objective of the transaction.
[If the Financing Structure chosen in Question 1 was Single-Borrower Guaranty, then the online form
will show the following]
For a Single-Borrower Guaranty, please provide a detailed list of the Borrower’s estimated costs, the
amount of the guaranteed party’s potential funding to the Borrower and the portion of that funding that
DFC would potentially guarantee. For an example, please click [here].
Borrower’s Estimated Costs
Cost Item

USD

Total Borrower Costs

100%

USD
Amount of Guaranteed Party’s
proposed Funding to Borrower
Amount of DFC’s Potential
Guaranty

%

%

Commented [HD(6]: From most recent (audited) financial
statement.

[If the Financing Structure chosen in Question 1 is Multi-Borrower Guaranty, then the online form will
show the following:]
For a Multi-Borrower Guaranty, please provide the parameters of the potential facility. For an example,
please click [here].
Total Size of the Portfolio
$
Avg. % of each sub-transaction to be guaranteed
by DFC
Estimated Number of SubTransactions/Borrowers

QUESTION 7: DESCRIBE COLLATERAL AND/OR CREDIT ENHANCEMENTS (IF APPLICABLE)
DFC usually requires a collateral/credit enhancement package tailored to the specific risks of a given
transaction. Following are indicative categories of collateral/credit enhancement that DFC may
require. Please indicate below those categories that may be available (check all that apply):
____ Pledge of shares of the Borrower
____ Liens/Mortgages on Borrower assets (Specify types/locations: ___________)
____ Liens/Mortgages on other assets (Specify types/locations: _____________)
____ Guaranties from creditworthy individuals or companies (Specify name(s) of guarantor(s): ____)
____ Irrevocable standby letter(s) of credit
____ Debt Service Reserve Account
____ “Key Man” Life Insurance
____ Other (describe:____________________________)

QUESTION 8: MANAGEMENT EXPERIENCE AND TRACK RECORD
Briefly describe relevant experience (in the sector, in the market, etc.) that the key parties (individually
or as a team) may contribute towards the success of the proposed transaction.
Please attach a document compiling CVs or other documentation that demonstrates this experience:
[insert required attach button]

Question 9: PROVIDE INFORMATION ON PRIVATE SECTOR SOURCES OF FINANCING
DFC does not compete with private sector providers of financing. Therefore, DFC requires that
applicants: (a) evaluate the possibility of obtaining financing from private sources and (b) decide to
pursue DFC financing because private financing is not available on terms sufficient to make the
investment viable or because of specific benefits DFC participation will bring to the investment.
Have you evaluated the possibility of obtaining financing for this transaction from private sector
sources?

Yes

No

Have you determined that private sector financing is not a viable option in this case?

Yes

No

If Yes, please list the private sector funding source(s) you have approached regarding this
transaction and explain why private financing is not a viable option (i.e. country capacity limits,
unworkable tenor and/or pricing).

QUESTION 10: CONSIDERATION FOR GRANT/TECHNICAL ASSISTANCE FUNDING
In situations where the investment being proposed is highly developmental and requires a grant or
similar funding for feasibility studies, training or other investment development activities, DFC may be
able to provide such funding. If the investment is successful to the extent that it becomes capable of
repaying this funding to DFC, then it would be required to do so.
Would you like to be considered for this type of funding? Yes/No
If Yes, please provide the following:
Amount Requested: USD_________
Description of the activities on which the funds would be used and how those activities are required
for the successful development of the overall investment:

QUESTION 11: HOW DID YOU LEARN ABOUT DFC?
DFC is interested in knowing what types of communications about its programs are most effective. If
this is the first time you are applying for a DFC product, please select the source of your initial
information about DFC:
N/A – This is not my first application to DFC
____ DFC’s website or other social media (Twitter, Facebook, etc.)
____ DFC-sponsored workshop or event (Name of event________________)
____ DFC speaker at an industry event (Name of event_________________)
____

Other US Government Agency (e.g. State/Embassy, Commerce, Treasury, TDA, DOD,
USEXIM, etc.) (insert a dropdown box with choices)

____ Referred by financial or legal advisor (Name of advisor ______________)
____ Referred by portfolio facility manager (Name of facility manager___________________)
____ Past or present DFC client. (Name of client _______________________)
____ Other (describe: ______)

SUBMISSION/SIGNATURE Page
Select DFC Origination Officer
Please select a recipient to receive your application materials. If you are already working with
a DFC origination officer, please select their name from the menu below. If not, please select
“Officer not assigned” and your application will be forwarded to a DFC officer who reviews
incoming applications.
Officer Name: (drop-down list)

I certify that the statements and information provided herein are true to and correct to the best of
my knowledge and belief.

Name:
Title/Role in Transaction:
Email Address:

[SIGN and SUBMIT BUTTON]

Note: Some of the questions in the form require the attachment of specific documents. In addition,
at the bottom of every page of the electronic form, there is a link that will allow the applicant to attach
additional supporting documentation as necessary. A list of the essential supporting documentation
requested by DFC is as follows:

SUPPORTING DOCUMENTATION
1. COMPLETE BUSINESS PLAN/PRELIMINARY INFORMATION MEMORANDUM
Since DFC supports a variety of transaction structures in many different sectors/industries and
countries, it is not possible to provide a standard business plan template. The following checklist
details the items that applicants may want to consider as they prepare their business plans. Please
provide as complete a business plan as possible.
Investment/Transaction Summary
• Investment/Transaction Description/Status Describe the purpose for which the DFC
loan/guaranty is to be used and any development activities completed to date -- investment made
to date, market or feasibility studies performed, status of documentation/permits/government
consents, environmental studies, past and ongoing consultations with project-affected
communities (including disadvantaged and vulnerable groups), etc.
• Financial Plan and Credit Support Describe the proposed DFC and other lender debt -- loan
amount, tenor, grace period -- and source, timing and amount of equity contributions, grants or
other funding; describe any proposed collateral and other credit support
Key Parties
• Owners/Shareholders, Guarantors, Management, Contractors, Regulators -- Provide
detailed information on the key parties associated with the transaction, fully explain their role(s),
and explain the relationships among them. If certain characteristics (e.g. a strong credit rating)
or capabilities/experience (e.g. a strong track record in a given market or industry) are important
to that party being considered a good candidate to fulfill their role in the transaction, please
highlight that information.
Sector/Target Market/Economics
• Sector/Industry Describe the competitive environment in which the investment is being made
and any recent or emerging trends that may affect its success.
• Product/Services Describe the ultimate products or services that this investment will produce, in
what quantity, and whether for the local market or for export (and if for export, to which countries)
• Economic/Technical Specifications If relevant, provide economic assumptions, technical
parameters, construction plans/schedule, equipment/land to be procured, off-take arrangements,
etc.
• Agreements List any key contractual arrangements necessary to the success of the investment
such as concession or franchise/royalty agreement(s), construction contract(s), offtake
agreement(s), environmental impact studies, feasibility studies, marketing studies, technical
assistance agreement(s), management services agreement(s), lease(s), etc. (and attach
electronically if available)
Legal, Economic, Political Environment and Government Participation
• Licenses/Permits List all licenses, permits, consents, approvals, environmental requirements etc.
required by the country/local government and the status of such documentation.
• Legal Regime List local laws, regulations or pending reforms that will impact the investment or
the sector.
• Economic/Political Climate Describe relevant economic and political factors in the
country/region where the investment is located.

• Government/Multilateral Participation Describe any government or multilateral involvement in
the investment or the sector and any government incentives such as tax holidays.
• Litigation or Dispute Resolution Describe any litigation or community dispute or complaint
resolution processes that have occurred or are occurring involving any of the key parties that
could affect this investment.
Transaction Strengths/Risks and Risk Mitigation
• Strengths Describe those factors that contribute to the long-term viability of the
investment/transaction.
• Risks Describe risks such as credit risks, sector/market risks and competition, operational and
management risks, political/economic risks, legal/regulatory risks and environmental, social and
human rights risks and what steps the Borrower/Guaranteed Party will take to mitigate such risks
and provide access to accountability and remedy for negative project impacts on individuals and
communities.
2. Financial Projections Model
The financial projections model should cover at least the entire proposed term of the DFC
loan/guaranty. It should include detailed, financially-justifiable assumptions on all key drivers of the
proposed transaction and should clearly demonstrate how funds provided or guaranteed by DFC will
be repaid successfully. The model should also include financial statements (i.e., balance sheet,
income statement, cash flow statement) and ratios or other financial measurements relevant to the
industry/transaction type being modeled. In addition, the model should be structured in such a way
as to make it simple to adjust key assumptions and thereby analyze potential financial performance
under adverse conditions.
If the applicant does not already have a financial projections model that meets these criteria, DFC
has provided a template (link to model template and user guides) that may assist some applicants in
creating a model. Please note that this template is not designed to model financial institutions or
other entities with lending or leasing portfolios.
3. Historical Financial Statements
Evaluating the financial strength of parties upon which the transaction will depend (primary investors,
guarantors, key contractors or off-takers) is an important part of DFC’s evaluation. For each such
party, please provide financial statements, preferably prepared in accordance with U.S. Generally
Accepted Accounting Principles (“U.S. GAAP”) or International Financial Reporting Standards
(“IFRS”). Financial Statements must be prepared in English or accompanied by a certified English
translation. Listed below are the types of financial statements that should be submitted for each type
of entity:
For a public corporation:

- 10K or equivalent (most recent 3 years)
- 10Q or equivalent (most recent quarter)

For a private corporation:

- Annual Financial Statement (preferably audited; most recent 3 years)
- Quarterly Financial Statement (most recent quarter)
- Tax Return (most recent 3 years)

For a partnership:

- Annual Financial Statement (preferably audited; most recent 3 years)
- General Partner information, including (i) current signed Statement of
Net Worth (assets, liabilities, net worth) and (ii) ownership

For an individual:

- Current Signed Personal Financial Statement (assets, liabilities, net
worth) – provide link to DFC-005 (fillable PDF)
- Tax Return (most recent 3 years)