Please provide the necessary information below to proceed with your Purchase Order Finance Application.

Please type carefully and fill out the form with accurate details.

Please enter the representative's full name as it appears on their ID.
Please enter the representative's ID/Passport number.
Please enter the amount you would like to borrow.
The type of service/facility being applied for.
Please enter the registered name of your business.
Please enter the industry in which your business operates.
Select the type of entity applying for the loan.
Please enter your business's official registration number.
Please enter the company's registration date.
Please describe the nature of your business.
Physical address of the business.
Postal address of the business.
Please enter a valid email address where we can contact you.
Please enter a valid telephone / mobile number where we can contact you.
How did you find out about Bellatrix SME Finance?
Is the business standing/providing surety for anyone?
Bank Name
Bank Account/Business Name
Bank Account Number
Bank Branch Name/Code
Select the type of entity or institution that issued the tender
Off-taker/Buyer Name
Name of the accounting officer for the offtaker.

Purposes

Select the purpose type.
Amount in N$ for the selected purpose

Liabilities

Name of the institution
Total amount of the principal loan in N$
Monthly installment amount in N$
Outstanding debt balance in N$

Directors

Full name of the person
ID or passport number of the person
Residential address of the person
Designation of the person (member, shareholder, director, or trustee)
Percentage of member interest or shares
Mobile number of the person
Email address of the person

Members

Full name of the person
Name of the institution and course studied
Name of the most recent employer
Telephone number of the most recent employer

References

Name of the employer or off-taker
Description of the project
Duration of the project
Contact information of the reference
Value of the project in N$
Location of the project


Supporting Documents

Upload a certified copy of the Managing Member's ID or passport (not more than 3 months old).
Upload the registration documents of your entity (Close Corporation, Private Company, or Trust).
Upload a Members’ resolution (if more than one member)
Upload the purchase order document.
Upload quotations from suppliers
Upload specifications sheet.
Upload a marriage certificate if applicable.
Upload bank confirmation letter.
Upload Delivery notes (if project partially completed)
Upload Quotations/Invoices of items already delivered (if project partially completed)
Upload the 6 months bank statement for the business (applicable to existing business only).
  • 1. Bellatrix SME Finance will be entitled to make enquiries about my payment profile and credit performance history for the purposes of compiling a credit assessment as provided for in the Bank of Namibia Act 1997: Credit Bureau Regulations (Regulation 15 and 16).
  • 2. The assessment will relate to both favourable and unfavourable credit performance information (Regulation 15 and 16).
  • 3. Bellatrix SME Finance will be obligated to provide such credit performance information to all credit bureaus and credit providers which have subscribed to receive credit performance information from credit bureaus, including both favourable and unfavourable information (Regulation 22).
  • 4. Without any notice to me, Bellatrix SME Finance will be obligated and entitled to inform credit bureaus in the event that I default on this credit agreement, fail to effect payment, or make late payments in terms of this agreement.
  • 5. I/We certify that the information given in this application represents a true and complete state of affairs of the company/business and grant permission for any source of information in respect of this application to be further investigated.
  • 6. I/We confirm that I am/We are not subject to any proceedings, under any form of administration or debt review as stipulated in the Insolvency Act 24 of 1936, and will disclose any details related if or where applicable.
  • 7. I/We consent to listing through Transunion/Compuscan or any other reputable Credit Bureau. In the event of default, and without any notice to me/us, Bellatrix SME Finance will be obligated and entitled to inform credit bureaus if I/we default on the credit agreement resulting from this application, fail to effect payment, or make late payments in terms of the agreement.
  • 8. I have satisfied myself of the meaning and consequences of the above-mentioned.