Information Request Form For Prospective Investee Company
A. Company Information
Company Name
Description
Products and/or Service
Sector
Sub Sector
Country
Head Office Location
Region
Type of Business
Select...
LLC
Sole Proprietorship
NGO
Tin #
Name of Solicitors
Name of Auditors
Name of Bankers
B. Company Profile
Founded By
Current Shareholding
Year of Incorporation
History of Business
Vision & Mission
Strategic Growth Priorities
C. Team Profile
Profile of Founder (s)
Profile of Management Team
Organizational Structure (Chain of Command in the Organization)
Board of Directors / Advisory Board
Staffing Needs
Technical Assistance (TA) Needs
D. Market Overview
Market Opportunity and Market Size
Competitive Landscape
Unique Selling Proposition
Regulatory Environment
Sales & Marketing Strategy
Impact Strategy
Strategic Industry Partnerships
E. Impact & Risk Management
Gender Equality (2x Criteria)
Environmental Impact
Social Impact
Regulatory Environment
SDG’s Targeted
Risks Identified
Risk Mitigations
F. Financial Snapshot - Past Year’s Financial Snapshots
Revenue
Year 1
Year 2
Year 3
Gross Profit
Year 1
Year 2
Year 3
Operating Expenses
Year 1
Year 2
Year 3
EBIT
Year 1
Year 2
Year 3
Net Profit
Year 1
Year 2
Year 3
Total Assets
Year 1
Year 2
Year 3
Cash Balance
Year 1
Year 2
Year 3
Total Liabilities
Year 1
Year 2
Year 3
Equity Position
Year 1
Year 2
Year 3
Financial projections
Revenue
Year 1
Year 2
Year 3
Gross Profit
Year 1
Year 2
Year 3
Operating Expenses
Year 1
Year 2
Year 3
Net Profit
Year 1
Year 2
Year 3
Total Assets
Year 1
Year 2
Year 3
Total Liabilities
Year 1
Year 2
Year 3
Equity Position
Year 1
Year 2
Year 3
Funding Needs
Detailed breakdown of use of Funds
G. Attachments
Please indicate the availability of the following documents and attach same where applicable.
Business Plan (including market research, marketing plan, etc.)
Detailed Financial Model (5 Year Forecast)
Company Registration Documents • Certificate of Incorporation • Form 3
Management Accounts • Balance Sheet • Income Statement • Cash flow Statement
Audited Financial Statements (3 years) • Past year • Past 2 years • Past 3 years
Tax Clearance Certificate for past financial year
Regulatory Approvals and licenses (if applicable)
Resume of Lead Promoter(s)
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