SFD Circular No. 04: Refinance Scheme for Environment Friendly Products/Projects/Initiatives - Annexure-3 and Annexure-4 Forms

Sustainable Finance Department Bangladesh Bank Head Office, Dhaka. Circular No. 04 Annexure-3/A: Information details of products/projects/initiatives related to refinance application. SFD Refinance Application Form No. 1 Details of loans disbursed for refinance under the product/project/initiative "................................." under the "Refinance Scheme for Environment Friendly Products/Projects/Initiatives". Name of Bank/Financial Institution: Name of the concerned Agent/MFI in loan disbursement:

Sr. No.	Customer Name	Address & Mobile No.	Amount and Date of Disbursed Loan	Interest Rate of Disbursed Loan	Purpose of Loan Disbursement (Expenses covered under loan)	Name, Address & Date of Loan Disbursement, Tenure and Grace Period of the Disbursing Branch	Details of the Product Applied Solely for Refinance regarding the Beneficiary Customer Count and Environmental Suitability of the Project. Production Capacity of Solar Panel and Amount of Electricity Generated (kWh)	Unique Code Number of Solar Panel	Daily Production Capacity of Biogas Plant and Number of Boilers Authorized by Bank	Daily Water Production Capacity and Motor Capacity of Solar Irrigation Pumping System	Amount of Organic Fertilizer Produced/Amount of Earthworm Compost Produced and Number of Boilers Authorized/Amount of Palm Oil Waste Produced
1	2	3	4	5	6	7	8	9	10	11	12
13

Special Remarks:

1. This form is applicable for the following products: 1, 15, 16, 17, 18, 66, 67, 68, 69.
2. The following documents must be submitted with the application: 1) Loan Sanction Letter, 2) Loan Account Statement, 3) Information regarding Agent/Intermediary (if applicable), 4) Project Inspection Report by Bank/Financial Institution (if applicable), 5) Certificate from Bank/Financial Institution stating that the customer has not availed refinance facility from any other source/institution against the refinance claimed from Bangladesh Bank, 6) Updated CIB Report, and 7) Other mandatory certificates required for the concerned product/project/initiative (if applicable).

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Sustainable Finance Department Bangladesh Bank Head Office, Dhaka. Circular No. 04 Annexure-3/B: Information details of products/projects/initiatives related to refinance application. SFD Refinance Application Form No. 2 Details of loans disbursed for refinance under the product/project/initiative "................................." under the "Refinance Scheme for Environment Friendly Products/Projects/Initiatives". Name of Bank/Financial Institution:

Sr. No.	Customer Name	Customer Address and Mobile Number	Amount of Disbursed Loan and Date of Loan Disbursement	Interest Rate of Disbursed Loan	Purpose of Loan Disbursement	Name, Address and Date of Loan Disbursement, Tenure and Grace Period of the Disbursing Branch	Brief Information regarding the Project (Production Capacity, Project Installation Cost, Loan-Capital Ratio of the Project, etc.)	Date of Project Commencement and Completion	Beneficiary Customer Count and Environmental Suitability of the Project
1	2	3	4	5	6	7	8	9	10

Special Remarks:

1. This form is applicable for all products/projects/initiatives other than those included in Forms 1, 3, and 4.
2. The following documents must be submitted with the application: 1) Loan Sanction Letter, 2) Loan Account Statement, 4) Project Profile, 3) Project Inspection Report by Bank/Financial Institution (if applicable), 4) Category-wise Expense of the Project and Authentic Documents in its favor, 6) Certificate from Bank/Financial Institution stating that the customer has not availed refinance facility from any other source/institution against the refinance claimed from Bangladesh Bank, 7) Environmental Clearance granted by Department of Environment (if applicable), 8) Fire License granted by Fire Services and Civil Defence (if applicable), 9) Updated CIB Report, and 10) Other mandatory certificates required for the concerned product/project/initiative (if applicable).

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Sustainable Finance Department Bangladesh Bank Head Office, Dhaka. Circular No. 04 Annexure-3/C: Information details of products/projects/initiatives related to refinance application. SFD Refinance Application Form No. 3 Details of loans disbursed for refinance under the product/project/initiative "...................................." related to Liquid and Solid Waste Management under the "Refinance Scheme for Environment Friendly Products/Projects/Initiatives". Name of Bank/Financial Institution:

Sr. No.	Customer Name and Address	Amount of Disbursed Loan and Date of Loan Disbursement	Interest Rate of Disbursed Loan	Purpose of Loan Disbursement (Expenses covered under loan)	Name, Address and Date of Loan Disbursement and Tenure of the Disbursing Branch	Daily Processing Capacity of the Project (Cubic Feet)	Date of Project Commencement and Completion	Count of Beneficiary Customers
1	2	3	4	5	6	7	8	9

Special Remarks:

1. This form is applicable for products: 28-39.
2. The following documents must be submitted with the application: 1) Loan Sanction Letter, 2) Loan Account Statement, 3) Project Inspection Report by Bank/Financial Institution (if applicable), 4) Certificate from Bank/Financial Institution stating that the customer has not availed refinance facility from any other source/institution against the refinance claimed from Bangladesh Bank, 5) Project Profile, 6) Category-wise Expense Breakdown of the Project and Authentic Documents in its favor, 7) Project Layout Design, 8) Updated Environmental Clearance granted by Department of Environment, 9) Copy of Updated Fire License, 10) Updated CIB Report, and 11) Other mandatory certificates required for the concerned product/project/initiative (if applicable).

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Sustainable Finance Department Bangladesh Bank Head Office, Dhaka. Circular No. 04 Annexure-3/D: Information details of products/projects/initiatives related to refinance application. SFD Refinance Application Form No. 4 Details of loans disbursed for refinance under the eco-friendly brick production product/project/initiative "................................." under the "Refinance Scheme for Environment Friendly Products/Projects/Initiatives". Name of Bank/Financial Institution:

Sr. No.	Customer Name and Address	Amount of Disbursed Loan and Date of Loan Disbursement	Interest Rate of Disbursed Loan	Purpose of Loan Disbursement (Expenses covered under loan)	Name, Address and Date of Loan Disbursement and Tenure of the Disbursing Branch	Type of Fuel Used in the Project	Annual Brick Production Capacity of the Project	Date of Project Commencement and Completion	Count of Beneficiary Single/Double Customers
1	2	3	4	5	6	7	8	9	10
11

Special Remarks:

1. This form is applicable for products: 46-48.
2. The following documents must be submitted with the application: 1) Loan Sanction Letter, 2) Loan Account Statement, 3) Project Inspection Report by Bank/Financial Institution, 4) Certificate from Bank/Financial Institution stating that the customer has not availed refinance facility from any other source/institution against the refinance claimed from Bangladesh Bank, 5) Category-wise Expense Breakdown of the Project and Authentic Documents in its favor, 6) Project Profile and Layout Design, 7) Updated Environmental Clearance granted by Department of Environment, 8) Updated CIB Report, 9) Copy of Updated Fire License, 10) Permission Letter from District Commissioner (if applicable), and 11) Other mandatory certificates required for the concerned product/project/initiative (if applicable).

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Sustainable Finance Department. Bangladesh Bank Head Office, Dhaka. Annexure 4: Quarterly Report regarding Refinance. Name of Participating Financial Institution: Quarterly: ............... to .................., 20......

Sr. No.	Date of Loan Disbursement	Tenure of Loan	Date and Reference No. of Refinance Received from Bangladesh Bank	Type of Project	Amount of Taka Payable	Loan/Investment Category Remarks
1	2	3	4	5	6	7
8

Special Remarks:

1. In the column "5" mentioned above, the name of the product/project/initiative must be mentioned as the type of project.
2. All banks/financial institutions that have signed the participation agreement with Bangladesh Bank will submit reports on a quarterly basis. Reports must be submitted based on the information of the preceding three months between January 15, April 15, July 15, and October 15 of the respective year. If any participating financial institution has not availed the refinance facility, it must submit a nil return.