Fill and Sign the Kappa Alpha Psi Code of Conduct Form

LEASEE’S PROFILE LEASE APPLICATION FORM CORPORATE LEASE NAME: …………………………………………. DATE OF INCORPORATION: …………………………… BUSINESS OFFICE ADDRESS: ………………… DATE OF COMMENCEMENT OF BIZ: ……………… …………………………………………………… PLACE OF INCOPORATION ……………………………. TELEPHONE: ………………………………….. EMAIL: ……………………………………………………... WEBSITE: …………………………………………………………………………………………………………. DETAILS OF SUBSCRIBERS/SHAREHOLDERS/SIGNATORIES NAME 1. 2. 3. 4. _______________________ _______________________ _______________________ _______________________ ADDRESS N SHAREHOLDING % SHAREHOLDING ____________________ ____________________ ____________________ ____________________ _______________________ _______________________ _______________________ _______________________ _________________ _________________ _________________ _________________ AUTHORIZED SHARE CAPITAL _______________________ PAID – UP CAPITAL _________________ MANAGEMENT BOARD OF DIRECTORS/PARTNERS NAME ADDRESS 1. ________________________ 2. ________________________ 3. ________________________ PHONE NO. ___________________ ________________________________ ___________________ ________________________________ ___________________ ________________________________ STAFF STRENGTH …………………………. CORPORATE STATUS Sole Proprietorship Partnership MAJOR CUSTOMERS 1. 2. 3. 4. 5. Enterprises Limited Liability Company NAME LOCATION CONTACT PERSON (NAME & PHONE NO) _______________________ _____________________ ______________________________________ _______________________ _____________________ ______________________________________ _______________________ _____________________ ______________________________________ _______________________ _____________________ ______________________________________ _______________________ _____________________ ______________________________________ PRINCIPAL BANKERS 1. 2. 3. 4. BANK NAME ________________ ________________ ________________ ________________ BRANCH ADDRESS ______________________________ ______________________________ ______________________________ ______________________________ ACCT. NUMBER ___________________________________ ____________________________________ ____________________________________ ____________________________________ DESIRED EQUIPMENT S/N ITEM DESCRIPTION UNIT PRICE SUGGESTED TENOR (tick the one applicable) 24 Months 36 Months 48 Months AMOUNT 60 Months EXISTING LOANS/OBLIGATIONS TO OTHER FINANCIAL INSTITUTION/THIRD PARTIES INSTITUTION TYPE 1. __________________ 2. __________________ 3. __________________ CERTIFICATION TOTAL AMOUNT START DATE END DATE EXPOSURE ________________ _____________ _____________ ____________ ________________ _____________ _____________ ____________ ________________ _____________ _____________ ____________ ________ ________ ________ I hereby certify and undertake that the information given above is true to the best of my knowledge. For: Name: _____________________________ MD/CHIEF EXECUTIVE OFFICER DATE……………………………… Note: This form attracts a non - refundable fee of N5,000.00.