Form DFC-015 MTU Intake Questionnaire (for Financial Institutions)

Initial Intake Questionnaire: Financial Institutions

In advance of discussing a potential partnership with the U.S. International Development Finance Corporation (DFC) and USAID, please complete and return to DFC. Please make your best effort to respond to all questions.

1. Contact Information
Institution name
Address
Contact name and title
Contact phone
Contact e-mail

2. Institution Background & Structure
Where is the business registered or incorporated?
How long has the institution operated in this country?
In what country/region are the business’ primary operations located?
What is the funding and ownership structure? Is the business privately owned or does a sovereign government own part or all of it? Please explain.
Does the institution have audited financial statements? Who did the audit?
Is the institution regulated by the local Central Bank? If not, why?
What is the institution’s experience with debt/guarantees?
Has the institution previously worked with international lenders, development finance institutions, or the DFC (formerly OPIC & USAID’s DCA)?
What are the institution’s environmental and social policies?

3. Transaction Specifics
What is the type and amount of financing/guarantee needed? (e.g, direct loan, partial credit guarantee, political risk insurance, equity investment, technical assistance)
What is the use of proceeds; what will the financial institution do with any new funds?
Are there any documents that can be shared to help explain the proposal? For example, a profile of the financial institution, business plan, summary of the project, list of what other entities the institution is speaking to for financial support, etc.
By when does the institution need the financing product?
If interested in a direct loan from DFC, what type of collateral are you considering to provide to the DFC?

4. Geographic Presence
In how many countries does the institution operate?
How many branches does the institution have in this country?
Where are these branches located?
What are the institution’s geographic expansion plans in this country?

5. Profitability
Is the institution currently profitable?
If not, please explain why.
If not, when does the institution anticipate being profitable?
Has the institution been profitable throughout the last three years?
If not, please explain why.

6. Current Debt (applicable only if seeking a direct loan)
Please provide all current debt, including terms and collateral.

7. Total Portfolio Size and Quality	2017	2018	2019
How many total customers does the institution have?
How many borrowers does the institution have?
How large is the loan portfolio? (Specify US$ or local currency)
What is the percentage of non-performing loans? (or PAR>30)

8. Lending Practices
Describe the institution’s target customer.
What is the average loan size? (Specify US$ or local currency)
What is the range of loan sizes? (Specify US$ or local currency)
What is the average lending interest rate?
What is the average deposit interest rate?
What is the average loan tenor?
What is the maximum loan tenor?
Describe typical collateral requirements.

9. Impact
Which sectors (i.e., agriculture, water, education, women, energy, infrastructure, etc.) does the institution currently prioritize?
In which sectors will the institution expand in the coming years?
What is the desired/intended impact of the potential DFC transaction? (number of jobs, etc.)