EQUITY FINANCE FORM - HBC

EQUITY FINANCE FORM - HBC

Contact information:

Mr Christopher Hess-WęgrzeckiM: +48 790 644 717 (English&German) E: [email protected]: hess-chris www.hessbusinessconsulting.info

QUICK FACTS FORM – EQUITY INVESTMENT

ALL FIELDS MUST BE COMPLETED

1. Applicant & ProjectName of Project:

Name of Applicant or Company:

Company Registration No.:

Description of Project:

Registered Address:

Holding Company (If Applicable)

Shareholder & Percentage Shares




Town/City: Country:

Tel No.: Fax No.

Contact Name: Position

E-Mail: Mobile

Project/Property Location Address

Town/City Country

2. Independent Contractors Details: (If Applicable)Name: Country

Tel No. Fax No.

E-Mail: Mobile

3. Equity Investment Required & Security Available

Page 1


Equity Required (in USD)

Term of Equity Required

Amount of Equity Available including land

Estimated Amount of Applicants free cash available

Estimated Market Value of Applicant’s free current assets

Applicant Co’s Share Capital

Project Execution / Construction Period

Amount of Draw Downs Required

Total Equity Participation

Total Debt Participation

Debt / Equity Ratio

Proposed Exit Strategy

Total Project Cost

4. Company HistoryIs this a Green or Brown Field project?

If Brown Fields, please supply information below.

In 2011 In 2012 In 2013 In 2014In 2015 (year to date)

Sales/Turnover Net Profit/Loss

5. Project Schedule

Anticipated Project Start Date Anticipated Completion Date Required funding schedule (amount required each year)

Start Year 1 Year 2 Year 3 Year 4 Year 5

Page 2


Project Returns

Start Year 1 Year 2 Year 3 Year 4 Year 5 EBITA

IRR: ROI:

Profit/Loss Forecast from Start Date

Start Year 1 Year 2 Year 3 Year 4 Year 5 Net Profit/Loss

6. ENCLOSURES

• Please supply full executive summary below • Please supply 5 years financial forecast • Please provide detailed Business Plan and or feasibility Study • Company Brochures

Page 3

Documents

EQUITY FINANCE FORM - HBC