1. Company Information

Company Name (Trade Name):

Trade License Number:

License Expiry Date:

Type of Business Activity:

Date of Establishment:

Legal Entity Type:

LLCSole ProprietorshipCivil CompanyFree Zone

If Others:

Company Address:

Office Phone Number:

Contact Person Phone Number:

Contact Person Name:

Contact Person Designation:

Email Address:

Website (if any):

2. Owner / Partner Details

Full Name (as per Emirates ID):

Nationality:

Mobile Number: +971

Email Address:

3. Business Financial Information

Annual Turnover (AED):

Monthly Revenue (AED):

Net Profit (AED):

Average Monthly Bank Balance (AED):

Existing Loans or Liabilities (if any):

YesNo

If Yes, Total Monthly Installments (AED):

4. Loan Requirements

Loan Amount Required (AED):

Purpose of Loan:

Working CapitalAsset PurchaseExpansion

If Other:

Preferred Tenure:

12 Months24 Months36 Months48 Months

5. Upload Documents

Trade License CopyEmirates ID and Passport Copies of All PartnersMOA / AOA or Partnership AgreementLast 6-12 Months Bank StatementsAudited Financial Statements (if available)Tenancy Contract / EjariVAT Return Report of Last 2-4 QuarterCompany Profile

6. Declaration

I/We hereby declare that the information provided above is accurate and complete to the best of my/our knowledge. I/We authorize SELCTUS Financing Broker LLC to verify and share the details with financial institutions in the UAE for the purpose of evaluating and processing this SME loan application.

Authorized Signatory Name:

Designation:

Signature:

Date: