Formal Request for Temporary Covenant Relief and Liquidity Support

1. Borrower Account & Credit Facility Metadata

This section captures fundamental borrower identification and facility-level reference data essential for credit file documentation and committee review.


Borrower Legal Entity Name

Borrower Master Account Number/Customer ID

Primary Industry Sector Classification

Specific Industry Sub-Segment

Facility Agreement Reference Number

Facility Type

Original Facility Commitment Amount

Current Outstanding Principal Balance


Facility Currency

Facility Agreement Effective Date

Current Facility Maturity Date


Primary Relationship Manager Name

Credit Officer/Underwriter Name

Tenure of Banking Relationship (Years)

Total Aggregate Exposure Across All Facilities


Current Internal Risk Grade

Is the borrower part of a larger consolidated group structure?


2. Covenant Breach Details & Financial Metric Delta Analysis

This section documents the specific covenant violation, quantifies the financial metric deviation, and assesses the severity and root cause of the breach.


Type of Covenant Breached

Specific Covenant Clause Reference (Agreement Section & Wording)

Covenant Threshold/Required Value

Actual Reported Value at Breach


Variance (Absolute Deviation from Threshold)

Variance Percentage ((Actual - Threshold)/Threshold * 100)

Covenant Testing Period End Date

Date Breach Was Identified and Reported


Is this the first instance of this specific covenant breach?


Trend Direction of Breached Metric

Root Cause Analysis of Covenant Breach

Contributing Factors to Covenant Breach (Select all applicable)

Financial Metric Delta Analysis - Comparative Trend (Last 4 Quarters)

Metric Name

Q-3 Value

Q-2 Value

Q-1 Value

Current Quarter (Breach)

Covenant Threshold

Consolidated Leverage Ratio
2.8
2.9
3.1
3.4
3
Interest Coverage Ratio
4.2
4
3.8
3.5
3.5
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

3. Borrower Liquidity Recovery & Restructuring Plan

This section evaluates the borrower's articulated strategy for restoring liquidity, returning to covenant compliance, and ensuring long-term viability.


Primary Nature of Liquidity Bottleneck

Detailed Description of Liquidity Constraint Mechanics

Expected Date of Liquidity Crisis Resolution

Estimated Liquidity Shortfall Amount


Recovery Plan Type

Specific Recovery Initiatives and Actions

Recovery Plan Milestone Tracking

Initiative/Action Item

Target Completion Date

Responsible Party

Expected Cash Impact

Completed?

Headcount reduction - 15% SG&A
4/30/2025
CFO/HR
$2,500,000.00
 
Sale of non-core manufacturing facility
6/15/2025
CEO/Advisor
$12,000,000.00
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Has management provided revised financial projections demonstrating return to covenant compliance?


Are third-party financial or operational advisors engaged?


Management's Narrative on Business Viability and Going Concern Assessment

Upload Borrower's Formal Recovery Plan Document (Board-approved if available)

Choose a file or drop it here
 

Upload Revised Financial Model with Sensitivity Cases (Base, Downside, Upside)

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Does the recovery plan assume any additional bank accommodation beyond this waiver request?


4. Bank Credit Exposure & Collateral Valuation Assessment

This section aggregates the bank's total credit exposure to the borrower and group, reassesses collateral valuation adequacy, and evaluates the impact on risk grading and provisioning.


Total On-Balance Sheet Exposure to Borrower (All Facilities)

Total Off-Balance Sheet Exposure (Guarantees, LC, Undrawn Commitments)

Aggregate Gross Exposure to Borrower (On + Off Balance Sheet)

Total Exposure to Borrower Consolidated Group (Including Affiliates)

Facility-Level Exposure and Security Package Detail

Facility Reference

Outstanding Amount

Primary Collateral Type

Latest Valuation

Valuation Date

Current LTV Ratio (%)

TL-A-2023
$45,000,000.00
Real Estate - Industrial
$65,000,000.00
9/30/2024
69.2
RCF-B-2023
$15,000,000.00
Accounts Receivable
$22,000,000.00
1/15/2025
68.2
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Has there been any material adverse change in collateral value since last formal valuation?


Is an independent third-party appraisal required for any collateral asset?


Assessment of Guarantor Support and Financial Strength (if applicable)

Proposed Risk Grade Classification Post-Waiver

Will this request trigger a provisioning impact under applicable accounting standards?


Overall Quality of Collateral Coverage and Mitigants

Key Credit Risks and Mitigating Factors

5. Senior Credit Committee Clearance Sign-Off

This final section consolidates the recommendation, risk assessment, and formal approval documentation required for Senior Credit Committee consideration.


Type of Accommodation Requested

Requested Waiver Effective Date

Requested Waiver Expiry Date


Duration of Waiver (Days)

Does the request include payment deferral?


Relationship Manager Recommendation and Rationale

Proposed Conditions Precedent to Waiver Effectiveness

Proposed Ongoing Conditions During Waiver Period

Recommended Approval Authority Level

Key Risks and Mitigation Strategies for Committee Consideration

Has the borrower agreed to pay a waiver fee or increase pricing?


Alternative Scenarios if Waiver is Not Granted

Upload Complete Credit Paper for Committee Review

Choose a file or drop it here
 

Relationship Manager Certification and Recommendation

Credit Officer/Underwriter Concurrence and Risk Assessment

Chief Credit Officer Approval (if delegated authority)

Final Submission Timestamp

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