Equity and Entrepreneurship Fund (EEF) Unit

Bangladesh Bank

Expression of Interest for ESF Loan to Established Food processing and agro-based projects
under the Entrepreneurship Support Fund (ESF)

(Please refer to the attached and related guide lines while filling the application form.
Read the given information/instructions carefully.)

1. Project Name:

2. General profile of the promoter/shareholder of the proposed project:

[Furnish information as per Annexure “A” for each entrepreneur/shareholder/director.]

3. Dependent on Project equipment Not Dependent on Project equipment

[Tick the applicable box and from the guidelines Note the definition of equipment dependent
project]

4. Nature of Project (Private Limited Company): a) Proposed b) Registered

[If Company is Proposed Attach Photocopy of Name Clearance Letter from Registrar of Joint
Stock Companies and Firms (RJSC) or If Company is registered on RJSC Attach Photocopy of
Certificate of Incorporation]

5. Proposed address of the project as per registered/name clearance:

……………………………………………………………………………………………

…………………………………………………………………………………………….

6. Address of Project Sight : Village/Mahalla ……………..Mouza: ………………………..

Khatian No: CS………… SA…………. RS………… BRS……….. CT Survey………..

Namjari……………….

Dag No: CS…….….. SA……………… RS………… BRS ………..CT Survey…………

Thana/Upazilla………… District…………… Post Code……………………….

 7. Identification of Project land as per Latest record:

Nature/class of land Amount of Land Mouza Price of Land Total price of Comment
(Ex: Nala, Doba, challa etc) (shatangsho) as per shatangsho Proposed land
1 2 3 4(2*3) 5

Sub total

8. Information about ownership of Project Land :

a) Name of the project Document no: ………….

b) Entrepreneur name by Source of Purchase Document no: ………….

c) Entrepreneur name by Warish d) Project name Registered earnest

(Tick the applicable box)

9. The project land is flood protected/flood controllable or nor

a) Floods free

b) Floods Controllable

c) Floods not Controllable

(Tick the applicable box)

10. Project communication system (should have good facilities for transportation of goods)

a) By Road

b) By River

c) Both

(Tick the applicable box)

11. Plot number of project land:

a) One part b) More than one

(Tick the applicable box)

12. If the project land located in more than one plot How many plot and Approximate Distance
between the two most distance plots:

a) Plot numbers………………
b) Approximate Distance between the two most distance plots………km
13. Project Type (Product name):
 a) Main Product:
b) Co-Product:
(If Applicable)
c) By-Product:
(If Applicable)

14. Product Market:

a) Local Market b) Foreign Market c) Both

15. Project Finance plan (in lakh taka):

a) Total Project Cost (100%):

b) Equity of Entrepreneur (51% of Project cost):

c) ESF Loan (49% of Project cost):

16. Information about EOI form submit fee (Non Refundable)

Bank Draft/ Pay order No…………………………………… Date: ………………….

Amount of money 2000/- in number & two thousand taka in words

Bank Name ………………………………………………………………………………

Branch Name ……………………………………………………………………………..

I hereby declare that the information stated in Serial No. 1-16 is true and correct. None of the
promoters/directors/shareholders of the project mentioned in the application form is approved or
applied for by ESF/EEF in any other project in food processing and agriculture based and ICT
sector. I am bound to accept any decision taken by the authorities to the contrary if the
information provided is found to be untrue or false.

Date: Signature:
Name:
Designation:
Company Name:
Address:
Telephone:
Mobile:
E-mail:

N.B: Applications containing incomplete/defective/false or incorrect information will be treated as

outright rejection.
17. Information about Project Directors/Shareholders must be filled:

1 copy passport Size Photo 1 copy passport Size Photo

attached with glue attached with glue

Signature: Signature:
Name: Name:
Designation: Managing Director Designation: Chairman/Director
Company Name: Company Name:
Address: Address:
Telephone: Telephone:
Mobile: Mobile:
E-mail: E-mail:

18. Information about Project Directors/Shareholders family members:

[As per Annexure B, Every Directors/Shareholders of the company has to provide information
separately]
 Annexure ‘A’

1 copy passport Size Photo

attached with glue

Name:
Fathers Name:
Mothers Name:
Husband Name:
Wife Name:
Designation:
National Id Number:
Birth certificate No:
Passport no:
E-TIN No:
Date of Birth:
Nationality:
Educational Qualification:
Present Address:
a) Road/Village:
b) Thana/Upazilla:
c) District:
Permanent Address:
a) Road/Village:
b) Thana/Upazilla:
c) District:
Mobile No:
Telephone No:
Company share Percentage (Not more than 80%)
Experience related to Project (years):

Signature:
 Annexure ‘B’

Information about Project Directors/Shareholders family members

Director/Shareholder’s Name:
Fathers Name:
Mothers Name:
Spouse Name:

Information of Son/Daughter (If more than one have to provide separately)

Name:
Relation with Director/Shareholder’s:
Date of Birth:
National Id Number:
Birth certificate No:
Passport no:

Information of Brother/Sister (If more than one have to provide separately)

Name:
Relation with Director/Shareholder’s:
Date of Birth:
National Id Number:
Birth certificate No:
Passport no:

Information of Dependents (If more than one have to provide separately)

Name:
Relation with Director/Shareholder’s:
Date of Birth:
National Id Number:
Birth certificate No:
Passport no:

I hereby declare that my husband/wife or parents, brothers/sisters, son/daughter or any person

dependent on me are not involved in any sanctioned project in EEF/ESF Food processing and
agriculture based ICT sector and no one has applied for ESF support for any project other than
the one under discussion.

Date:
Signature of Director/Shareholder’s