GUARANTEE
APPLICATION FORM
Date: D D MM Y Y Y Y
CUSTOMER INFORMATION
Customers Name Account No.
GUARANTEE DETAILS
• Applicants Name & Address
• Beneficiary Name & Address
• Currency Amount (Figures)
• Currency & Amount (in Words)
• Guarantee Type Tender No.
• Contract /Tender Details
• Expiry Date D D MM Y Y Y Y Tenor/Validity Period
Collateral Details
Kindly tick as appropriate 1) Cash 2) Facility 3) Other
Settlement Details
Account to debit for 1) Charges 2) Cash
Collateral
APPLICANTS DECLARATION
• I/We certify that the information contained in this application is true and correct to the best of my/our knowledge and belief and
will form the basis of the guarantee that Family Bank Limited may decide to issue to me /us
• I/We agree with the INDEMNITY terms and conditions stated at the back of this application form.
1. Signature and Date
4. Company Stamp/Seal
2. Signature and Date
(If any)
3. Signature and Date
Note
Please attach a copy of the agreed guarantee format as part of this application.
INDEMNITY TERMS AND CONDITIONS
TO: FAMILY BANK LIMITED
In consideration of your giving or continuing to give a (n) indemnity/Guarantee/Bond in terms of the copy appended
or attached hereto (which I/We have verified and signed) and extending and/or amending it from time to time at my/
our request I/We jointly severally for myself/ourselves and my/our legal personal representatives successors and assigns
hereby:
a) agree to keep you indemnified against all actions proceeding liability claims losses damages costs and
expenses in relation to or arising out of the said indemnity/Guarantee /Bond as extended from time to time
at my/our request and to pay you on demand all payments losses costs interest payable there under and
expenses suffered or incurred by you in consequence thereof or arising there out; and
b) irrevocably authorises you to debit my/our account with all such payments losses costs interest and expenses
or to set off without prior reference to me/us any amounts so paid by you against any sums of monies which
you may at such time owe me/us
c) irrevocably authorise you to make any payments and comply with any demands which may be claimed from
or made upon you under the said Indemnity/Guarantee/Bond without any reference to or further authority
from me/us and agree that it shall not be incumbent upon you to enquire whether or not any such payments
or demands claimed from or made upon you under the said indemnity/Guarantee/Bond are in fact due or
whether or not any dispute exists between myself/ourselves and the beneficiary(ies) of the said indemnity/
Guarantee/Bond and further agree that any payments which you shall make in accordance or purporting to
be in accordance with the said Indemnity/Guarantee/Bond shall be binding on me/us and shall be accepted by
me/us as conclusive evidence that you were liable to make such payments or comply with such demand and
further that you may at any time determine the said indemnity/Guarantee/Bond.
d) agree and undertake to deposit with you upon request made by you at any time until the said Indemnity /
Guarantee / Bond shall have been released such or other securities as may be acceptable to you in full or
part cover of your liability under the said indemnity / Guarantee / Bond.
