Application Form Introduction

Loans to pharmacists Acquisition Questionnaire / Application form

There are many questions to ask when you are contemplating the purchase of a pharmacy and no matter how thorough you are, there is bound to be something which gets forgotten.

With this in mind, we have designed the attached acquisition questionnaire to help you. This can be printed off and sent to the vendor with a request that they complete it and return it to you. Whilst all the questions may not be relevant to every situation, we believe that it covers most of the important areas of which you need to be aware, when making such a large financial commitment.

When you apply for a loan, it would be helpful for a copy of the questionnaire to be submitted together with the loan application form and other information.

You may print off the application form from this link. Please ensure that all parties sign both the form itself and the bank disclosure authority and send to:

Statim Finance Ltd.,
Sapphire Court,
Walsgrave Triangle,
Coventry.
CV2 2TX

Accompanied by the following additional information:

	3 years historical accounts for existing and new businesses
	12 months NHS prescription summary statements (FP34; PPD9 etc.) Full details required
	Map of the area with pharmacies & doctors marked
	6 months-existing wholesaler statements (not required from existing AAH customers)
	Certificate of Incorporation (limited companies only)

N.B. Please ensure that all relevant sections are completed and that the enclosures above are attached. Failure to provide all information may delay the processing of the application.

Building partnerships with people.