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» Application Form
1- Full name of the Applicant(s): (person, firm, etc.)
a.
b.
c.
2- Legal status of the Applicant(s):
3- Nationality and legal domicile of the applicant(s) (full address) :
a.
a) Tel 
a) Fax
a) E-mail  
a) WebSite
b.
b) Tel 
b) Fax
b) E-mail
b) WebSite
c.
c) Tel
c) Fax
c) E-mail
WebSite
4- Countries in which the Applicant(s) has implemented similar projects:
5- References (banks, industrial and business personalities):
B. The Project:
6- Title of the Proposed Project/Activity in which the Applicant(s) intends to invest:
7- Project description and objectives:
8- Project Status:
 
9- Project Location:
10- Total Project cost, including working capital:
Fixed cost:
Working capital:
Total:
11- Applicant's contribution to the project cost (The Foreign Capital):
Equity capital:
Shareholder's loan/credit:
Total:
b) Foreign share (percentage) in the equity capital of Direct Investment Enterprise:
c) Terms and conditions of the sharehloder's loan(s)/credit(s):
Amount 
Rate
Repayment Period (in years)
No. of Installments
12- Terms and conditions of planned or anticipated foreign loan(s)/credit(s)
Amount 
Rate
Repayment Period (in years)
No. of Installments
Lender
13-Type of Foreign Capital to be contributed to the Project by the Applicant(s):  



14- Local Funding (if applicable):
Local equity capital:
Local loan(s)/credit(s):
Total:
b) Name of local shareholders/parties( firms or persons):
a.
b.
c.
15- Project Implimentation Timetable (Key Milestones):
a.
b.
c.
d.
e.
16- List of main permits, clearances and licenses required to be obtained from lranian official authorities:
a.
b.
c.
17- Contact person information:
Name:
Title:
Company:
Address:
Tel:
Fax:
E-mail:
Date & Time 3/10/2010 4:38:32 PM
 
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