Sugarcane - Fiji Development Bank

Sugarcane Farmers Special Loan Facility

APPLICATION FORM

TYPE OF BUSINESS

Type of Business

Sole Trader Partnership Company Cooperative

Required Field

DETAILS

Courtesy Title	First Name	Surname	Date of Birth
Required Field	Required Field	Please leave blank if not applicable	Required Field Format

Gender	Residential Address	Province	Nationality
Required Field	Please leave blank if not applicable	Required Field	Required Field

Postal Address	Name of Business	Business Location	TIN (Numbers only, without dash)
Please leave blank if not applicable	Required Field	Required Field	Enter numbers only(without dashes), Minimum length 9, Maximum length 10

Home Phone	Mobile Number	Business Contact	Email
Please leave blank if not applicable	Required Field	Required Field

FNPF Number	Driving License Number	Nearest Branch	Marital Status
Please enter valid FNPF Number or leave blank	Please leave blank if not applicable	Required Field	Required Field

Spouse Name	Spouse Contact	Number of Dependents	Age of Dependents
Please leave blank if not applicable	Please leave blank if not applicable	Required Field	Please leave blank if not applicable

Current Occupation	Educational Attainment	Income
Required Field	Required Field	$0,- $5,000 $5,001- $10,000 $10,001- $20,000 $20,001- $30,000 $30,001- $50,000 $50,001+ Required Field

BANK DETAILS

Bank Account Name	Bank Account Number	Bank Name
Required Field		Required Field

DISABILITY

Are you living with any form of disability?
(Disclaimer: Please note that FDB will only share statistical data with the Reserve Bank of Fiji. FDB does not discriminate against any form of disability) Required Field

LOAN DETAILS

Loan Type	Loan Classification
New Customer Further Loan (FDB Existing Customer)	Agriculture

Loan amount sought from Fiji Development Bank	Provide brief details (Short Paragraph) on the Purpose of loan
Required Field

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DECLARATION

Are you/or any of your company directors/shareholders an Un-Discharged Bankrupt, under Official Receiving Order or has assigned total personal or business estate for the benefit of creditors? If Yes, please provide details
Is the company /or any related company under Receivership? If Yes, please provide details
Have you /or any directors/shareholders of the company been involved in a company that was liquidated or under Receivership? If Yes, please provide details
Has any application for any loan to any bank ever been declined? If Yes, please provide details

UPLOADS

Birth Certificate *

Photo ID: Voter Identification Card/Driving License/Passport/Joint FRCS/FNPF Card *

Joint FRCS/FNPF card and TIN Letter confirming the tax identification number *

Title, current lease or approval notice over land to be used. *	thi

Established Cane Farmer - certified FSC production record (past 3 years production).

Current Certificate of Registration (if applicable).

Quotations and detailed project cost.

Quotations and detailed project cost

Quotations and detailed project cost

For vehicle purchase – LTA Certificate of Road Worthiness for the vehicle and current driving license in the category of the vehicle to be purchased.

For those who had applied for the lease transition from sugarcane lease to agriculture lease with the Government, approval letter from the Fiji Government must be provided.

Evidence of equity – contribution towards the project (bank statement/other evidence).

Securities required as per loan categories.

Securities required as per loan categories.

Securities required as per loan categories.

(A loan decision will not be made unless these documents are uploaded here.)

DISCLOSURE

The Applicant’s attention is drawn to Section 41 of the Fiji Development Act [Cap 214] Ordinance 1966 which reads;

“If you willfully fail to disclose any material information within your knowledge, or willfully make any statement which you know
to be false or does not believe to be true, for the purposes of securing a loan from, or any investment in any form by, or assistance
in any form or any facility from the Bank, you shall be guilty of an offence and on conviction shall be liable to a fine not exceeding
one thousand dollars or to imprisonment for a term not exceeding two years, or to both such fine and imprisonment”.

I/We certify that the information contained in this application and in all continuation sheets attached is true, accurate and complete in every particular. You are authorized herewith to request any information you may require regarding my/our accounts and financial arrangements with my/our Bankers or other financial Institution or my/our creditors.
Required Field

The Fiji Development Bank (FDB) does not collect personal information for commercial marketing or distribution to any
private organizations, except for reporting with the Reserve Bank of Fiji.