Name of Business:

Legal Form: ] Sole Proprietorship [] Corporation

] Partnership j-j Cooperative

Business Type: ] Manufacturing Trading

[] Service [] Retail
[] Agribusiness 0
Wholesale

Customers:

Products and/or services:

Owner(s):

Number of staff or employees:

Fund Requirement and Sourcing:

Source of Funds
Requirement
Total Cost Equity Other Sources OWWA Loan

s Fixed Assets:

Building Construction/Renovation

Machineries and Equipment Furniture

and Fixtures Working Capital

Totals