Application for Investment under the FIPPA

Islamic Republic of Iran Ministry of Economic Affairs and Finance

Organization for Investment, Economic and Technical Assistance of Iran

(O.I.E.T.A.I.)

A. The Applicant(s): 1- Full name of the Applicant(s): (individual or firm)

I......................................................................................................................... II........................................................................................................................ III ...................................................................................................................... 2- Legal status of the Applicant(s): private state owned other (If other, give more information): ......................................................................................................................... 3- Nationality and legal domicile of the applicant(s) (full address) : I.......................................................................................................................... Tel:....................Fax:...................E-mail:............................Website:............................ II.................................................................................. ………............................... Tel:....................Fax:...................E-mail:........................... Website:............................ III................................................................................. ………............................... Tel:....................Fax:...................E-mail:........................... Website:............................ 4- Countries in which the Applicant(s) has implemented similar projects: .......................................................................................................................... 5- References (banks, industrial and business personalities): .........................................................................................................................

B. The Project: 6- Title of the Proposed Project/Activity in which the Applicant(s) intends to

invest: ............................................................................................................................ 7- Project description and objectives: .............................................................................................................................. ............................................................................................................................. .............................................................................................................................. 8- Project Status: New Existing

Note: In case of new projects submission of copy of the Establishment License issued by the relevant Ministry and/or Government agency is mandatory.

9- Project Location: .............................................................................................................................

Page 1/3 Application Form

OIETAI, Tehran- Iran P.O.Box: 11365/4618, Tel: +9821 33967755/33967075, Fax :33967864 , Website: www.investiniran.ir

10- Total Project cost, including working capital: (Express in Foreign Currency and specify the Currency unit)

Fixed cost: Working capital: Total:

11- Applicant's contribution to the project cost (The Foreign Capital): (Express in Foreign Currency and specify the Currency unit) a)

Equity capital: Shareholder's loan/credit:

Total:

b) Foreign share (percentage) in the equity capital of Direct Investment Enterprise:

c) Terms and conditions of the sharehloder's loan(s)/credit(s): Amount Rate Repayment Period (in years) No. of Installments 12- Terms and conditions of planned or anticipated foreign loan(s)/credit(s) (if applicable): Amount Rate Repayment Period (in years) No. of Installments Lender

13-Type of Foreign Capital to be contributed to the Project by the Applicant(s): (Express in Foreign Currency and specify the Currency unit)

a) Cash;

b) Machinery and equipments;

c) Tools and spares, CKD parts and raw, addable and auxiliary materials;

d) Patent rights, technical know-how, trade marks and names, and specialized services;

Note: 1- In case the Foreign Capital is planned to be imported in the form mentioned in items b and c

above detailed list of the same be attached herewith if available. 2- In case the Foreign Capital is planned to be imported in the form mentioned in item d above

detailed information along with any documentation regarding the valuation or registration of the same in the home country of the foreign investor or a third country also must be attached.

14- Local Funding (if applicable): (Express in Foreign Currency and specify the Currency unit) a)

Local equity capital: Local loan(s)/credit(s): Total:

b) Name of local shareholders/parties(individual or firm): I............................................................................................................................ II........................................................................................................................... III .........................................................................................................................



15- Project Implimentation Timetable (Key Milestones):

1. 2. 3. 4. 5.

16- List of main permits, clearances and licenses required to be obtained from lranian official authorities:

Title/Description Official agency in charge I................................................................................................................................... II.................................................................................................................................. III ................................................................................................................................ 17- Contact person information:

Name: Title: Company: Address: Tel: Fax: E-mail:

18- The applicant is required to provide the following documents along with

the completed application form at the time of submission of the application to the OIETAI (please tick):

A covering letter by the Applicant(s) addressed to the OIETAI, stating Applicant’s request for approval under the FIPPA.

Short resume of Applicant(s), Corporate brochures and recent annual reports (Audited Financial Statements) and the same for the local direct investment enterprise if applicable. In case of individual applicant(s), copy of valid passport is required. Copy of the Joint Venture Agreement (if applicable).

Original copy of power of attorney for the person signing this form.

Any other document deemed to be helpful. (express the title of document)

Having read the Foreign Investment Promotion and Protection Act (FIPPA) as well as its implementing regulations, I, .......................................as authorized by the power of attorney enclosed/in my capacity as………..….. (title/company), confirm that the information submitted in this form is credible and is, in no part, intended to be misleading. On behalf of the Applicant(s): Name: Title: Company: Signature:

Date: .........................Stamp On behalf of the local shareholder(s): Name: Title: Company:

Signature: Date: .........................Stamp Note: This form should be submitted in typewritten. In case the space designated for each question of the

application form is not sufficient to cover the answers, the Applicant(s) are kindly requested to attach additional pages as required.



Law

Application for Investment under the FIPPA