Enterprise Financing Questionnaire

Captures a company's full financial profile: revenue, export markets, audit history, and capital needs. Built for credit analysts and development programs assessing whether small and medium enterprises qualify for funding.

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Page 1

Welcome and instructions

Page 2

About this questionnaire

Data confidentiality

Page 3

1.1.1: In which country is the enterprise being surveyed based?

1.1.2: Name of the enterprise

1.1.3: Respondent Name

Nombre

Apellido

1.1.4: Respondent position / title in the enterprise

1.1.5: Respondent Email

1.1.6: Enterprise HQ Address

Dirección

Ciudad

Estado / Provincia

Código postal

Location note

1.1.8: Enterprise contact phone number

1.1.9: Enterprise Website

1.2.0: Enterprise Tax or Registration Identification code

1.2.1: Type of identification code provided above

1.2.2: What are your latest enterprise plans in 600 characters

1.2.3 Please select the type of entity you represent

Financial section

1.2.4: Exchange rate applied to get US$ from UGX

1.2.4a: Enterprise total annual revenue for the Previous financial year in US$ equivalent

1.2.5: Phone Number

1.2.6: Select the band below that best represents the Previous year's annual revenue for your enterprise in US$

Under US$100,000 US$100,000 – 500,000 US$500,000 – 1 million US$1 – 5 million Over US$5 million

1.2.7: Main revenue-generating products and services value. Start with the highest value product or service, then the next highest by value, Maximum 5 choices

1.2.8: Enterprise total annual revenue Forecast for the current financial year in US$ equivalent

1.2.9: Export only annual revenue Forecast for the current financial year in US$ equivalent

1.3.0: Domestic only annual revenue Forecast for the current financial year in US$ equivalent

1.3.1: Approx. what % of total annual enterprise revenue are production and delivery costs (ie: Cost of sales)

Page 4

2.1.1: In which year did your company start operations?

2.1.2: Select your enterprise growth stage

Startup Early growth Expansion Mature

2.1.3: Have your financial statements been audited and, if so, for how many years?

Never audited Audited for 1 year Audited for 2 years Audited for 3+ years

2.1.4: Sales destinations: Insert name of main product or service delivered to a destination, the % of total sales value and number of years sales to the same buyers or customers.

2.1.7: How have you been financing your enterprise growth for the past 3 years?

Retained earnings Bank loans Investor equity Family and friends Grants Supplier credit

2.1.8: Are business costs / sales seasonal or consistent throughout the year

Seasonal sales Seasonal costs Consistent year-round A mix of both

2.1.9: How do you finance procurement from suppliers?

2.2.1: Apart from ITC's NTF IV project, enter the name of any other development projects or organisations supporting your enterprise

2.2.2: What topics would you like to improve your knowledge of:

Export finance Financial management Digital marketing Trade regulations Sustainability Business planning

Page 5

3.1.0: How has your business been affected by COVID-19?

3.1.1: How much external capital / equipment financing in US$ equivalent do you plan to raise next year to repay > 1 year?

None Under US$50,000 US$50,000 – 250,000 US$250,000 – 1 million Over US$1 million

3.1.2: How soon would you plan to fully payback capital or equipment financing of > 1 year?

Within 2 years 2 to 3 years 3 to 5 years Over 5 years

3.1.5: Which bank(s) does your enterprise use to receive international payments?

3.1.6: Which banks do your buyers use to pay you in the main sales markets listed above in Q 2.2.1 and Q 2.2.2?

3.1.7: Insert comments here about how the COVID-19 crisis has affected relations with your bank or your financing options.

Thank you for participating

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