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Diakuakaye Wu

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贷款卡业务申请书 借款人全称: 辽阳和祥投资有限公司 组织机构代码: 59480089-9 贷款卡编码: 法定代表人(负责人): 马志义 身份证件号码: 211004196410257814 经办人:刘毅 身份证件号码: 211002198510162018联系电话:13841989270

|申 请 人 承 诺 |
|本报告书中所填情况、数据及附送的报表均属实。如有虚假,愿接受人民银行照章处理。特此承诺。 |
|法定代表人(负责人)签字 ____ ____ |
|单位盖章: |
|财务负责人签字:____ ____ |
| |
|经办人签字:____ _____ |
| |
|年 月 日 |
| 金融机构意见 |人民银行审查意见 |
| | |
| | |
| |经办人员签章: |
|金融机构盖章: | |
| |复 核 人签章: |
| | |
|经办人员签章: |审 批 人签章: |
| | |
|年 月 日 |年 月 日 |

注:“金融机构意见”是否填写由当地人民银行具体决定
中国人民银行沈阳分行

表一、基本概况信息

|借款人性质* |企业法人 |借款人国别* |中国 |
|借款人中文名称* |辽阳和祥投资有限公司 |
|借款人外文名称 | |
|行政区划* | 辽宁 省 辽阳 市 宏伟 县(市、区) |
|组织机构代码* |59480089-9 |登记注册号 |211000004050386 |
|登记注册日期* |二〇一二年四月十七日 |营业执照到期日* |二〇二二年四月十七日 |
|国税登记证号码* | |地税登记证号码* |211004594800899 |
|登记注册类型* |其他有限责任公司 |行业分类* |J71其他金融活动 |
|基本账户开户行* |交通银行辽阳辽化支行 |
|借款人特征* | 小型企业 |从业人数* |10 |成立年份* |二〇一二 |
|注册地址* |辽阳市宏伟区宏伟路西侧6-4号303室 |
|通讯地址* |辽阳市宏伟区宏伟路西侧6-4号303室 |邮政编码* |111003 |
|借款人联系电话* |0419-4155576 |借款人传真号码 | |
|借款人E-mail地址 | |借款人网址 | |
|财务部门电话1* |0419-4155576 |财务部门电话2 | |
|集团客户标志(是/否) | 是 否 |进出口权标志(是/否) | 是 否 |
| | 是 否 |上市地1 | |股票代码1 | |
|上市公司标志(是/否) | | | | | |
| | |上市地2 | |股票代码2 | |
| | |上市地3 | |股票代码3 | |
|经营场地面积 | m2 |经营场地所有权 | |
|主要产品情况 |实业投资、资产管理、投资管理(以上各项均不含许可经营项目) |
|(非生产企业填写主要经营范围) | |
|经办人 | |证件类型* | |证件号码* | |

表二、资本构成信息

(一)注册资本信息
|注册资金币种* |注册资金(万元)* |
|人民币 |捌仟 |
| | |

说明:请按《法人企业营业执照》上载明的“注册资本”填写。
(二)资本构成情况
▲单位出资情况:
|出资单位全称* |出资单位证件号码* |出资情况* |
| |贷款卡编码 |组织机构代码 |登记注册号 |币种* |金额(万元)* |
|辽阳和泰祥投资有限公司 | | |211000004049886 |人民币 |8000 |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |

▲ 自然人出资情况:
|出资人姓名* |身份证件类型* |身份证件号码* |出资情况* |
| | | |币种* |金额(万元)* |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |

说明:(1)本表以企业最新的《验资报告》等出资证明材料上的信息为准;对于资本或股东变更的借款人,以工商部门的出资证明变更材料为准。 (2)若出资方为企业,应填写出资单位贷款卡编码、组织机构代码、登记注册号中的至少一个;若出资方为自然人,应填写出资人身份证件类型和身份证件号码。

(三)对外投资情况
|被投资单位全称 |被投资单位证件号码 |出资情况 |
| |贷款卡编码 |组织机构代码 |币种 |金额(万元) |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |

说明:被投资单位证件号码至少选填“贷款卡编码”和“组织机构代码”中的一个。
表三、高级管理人员信息
|姓 名* |基 本 情 况 * |工 作 简 历 * |
| |高管类别* |法定代表人 |性 别* |男 | |
|马志义 | | | | | |
| |证件类型* |身份证 |证件号码* |211004196410257814 | |
| |出生年月* |196410 |最高学历* |大专 | |
| |高管类别* | |性 别* | | |
| |证件类型* | |证件号码* | | |
| |出生年月* | |最高学历* | | |
| |高管类别* | |性 别* | | |
| |证件类型* | |证件号码* | | |
| |出生年月* | |最高学历* | | |

说明:高管类别:分为法定代表人、总经理、财务负责人等。
表四、法定代表人家族成员信息
|家族关系* |姓 名* |家族成员信息* |家族成员所在企业信息* |
| | |证件类型* | |企业名称* | |
| | |证件号码* | | | |
| | |证件类型* | |企业名称* | |
| | |证件号码* | | | |
| | |证件类型* | |企业名称* | |
| | |证件号码* | | | |
| | |证件类型* | |企业名称* | |
| | |证件号码* | | | |

说明:家族关系:分为配偶、父母、子女、其他血亲、其他姻亲。

表五、集团公司/母子公司信息
|上级(母)公司名称 |辽阳和泰祥投资有限公司 |
|上级(母)公司贷款卡编码 | |上级(母)公司组织机构代码 |59093650-2 |

说明:若有上级(母)公司,则“上级(母)公司贷款卡编码”、“上级(母)公司机构代码”中至少选填一项。
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