Initial Intake Questionnaire: Non-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 |
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Company name |
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Address |
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Contact name and title |
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Contact phone |
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Contact e-mail |
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2. Institution Background & Structure |
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Where is the business registered or incorporated? |
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What does the company do and what is the company’s plan for the future? |
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How long has the company operated in this country? |
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What is the company’s funding and ownership structure? Is the business privately owned or does a sovereign government own part or all of it? Please explain. |
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Does the company have audited financial statements? Who did the audit? |
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What is the company’s experience with debt/guarantees? |
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What are the company’s environmental and social policies? |
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3. Transaction Specifics |
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What is the type and amount of financing/guarantee is needed? (e.g, direct loan, partial credit guarantee, political risk insurance, equity investment, technical assistance) |
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What is the use of proceeds; what will the company do with any new funds? |
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Are there any documents that can be shared to help explain the proposal? Cash flow projections, business plans, etc. |
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When does the company need the financing? |
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If interested in a direct loan from DFC, what type of collateral are you considering to provide to the DFC? |
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4. Profitability |
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Is the company currently profitable? |
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If not, please explain why. |
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If not, when does the company anticipate being profitable? |
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Has the company been profitable throughout the last three years? |
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If not, please explain why. |
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5. Current Debt (applicable only if seeking a direct loan) |
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Please provide all current debt, including terms and collateral. |
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6. Impact |
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Which sectors (i.e., agriculture, water, education, women, energy, infrastructure, etc.) does the company currently prioritize? |
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In which sectors will the company expand in the coming years? |
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What is the desired/intended impact of the potential DFC transaction? (number of jobs, etc.) |
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File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Ramirez, Sofia (SME) |
File Modified | 0000-00-00 |
File Created | 2021-05-03 |