Membership – Invest Madagascar

SECTION 1 — APPLICANT / ORGANIZATION PROFILE

Applicant Type:

Full Legal Name (Individual / Entity):

Nationality / Country of Incorporation:

Passport / Registration Number (if applicable):

Registered / Residential Address:

City

State/Province

Country

Primary Contact Person:

Designation / Role:

Email / Phone / WhatsApp:

Website (if applicable):

SECTION 2 — ORGANIZATION SNAPSHOT (If Applicable)

Years in Operation

Number of Employees

Annual Turnover / Assets Under Management (USD):

Primary Sector(s) of Activity (Select up to 3):Manufacturing & Industrial DevelopmentRenewable Energy & Climate InfrastructureTourism & HospitalityInfrastructure / PPP / ConcessionsHealth & EducationTechnology / Smart Systems

SECTION 3 — MADAGASCAR ENGAGEMENT INTENT

Purpose of Engagement:

Estimated Investment Size (USD):

Expected Investment Timeline:

Brief Description of Proposed Activity / Interest in Madagascar:

Support Required from Invest Madagascar (Select all applicable):Government Interface & FacilitationLand / Permits / LicensingLocal Partners & Joint VenturesSPV / Structuring AdvisoryESG & Compliance SupportFinancing / Incentives / Blended Finance

SECTION 4 — ESG & SUSTAINABILITY ALIGNMENT

Primary ESG Impact Focus Areas (Select 3–4):Job Creation & Skills TransferBiodiversity & Water ConservationRenewable Energy & Carbon ReductionCommunity & Social DevelopmentCircular Economy / Waste ReductionGovernance, Transparency & Compliance

ESG Readiness Status:ESG Framework ImplementedWilling to Implement ESG FrameworkRequires ESG Support & Advisory

SECTION 5 — TOKENIZED & ESG INCENTIVE OPT-IN (VOLUNTARY)

Invest Madagascar facilitates innovative, sustainable investment frameworks, which may include ESG-linked incentives, digital impact tracking, and tokenized real-world asset (RWA) mechanisms, subject to regulatory compliance.

Please indicate your preference (optional):Interested in Tokenized ESG Incentives (carbon, energy, water, social impact)Interested in Performance-Linked ESG Credits / Impact CertificatesInterested in Digital MRV & ESG Impact DashboardsInterested in Blended Finance / Green Bonds / Climate Finance StructuresPrefer Conventional (Non-Tokenized) Investment Framework Only

Preferred Incentive Focus Areas (if opted-in):Carbon Reduction / Offset-Linked IncentivesRenewable Energy Yield / Credit MechanismsJob Creation & Skills Impact CreditsCommunity & Social Infrastructure Impact

SECTION 6 — COMPLIANCE DECLARATIONS

SECTION 7 — REFERENCES (OPTIONAL BUT RECOMMENDED)

Reference 1:

Name

Text

Email Address

Phone

Reference 2:

Name

Text

Email Address

Phone

SECTION 8 — DECLARATION & AUTHORIZATION

I hereby declare that the information provided is complete, accurate, and truthful. I authorize Invest Madagascar to conduct standard due diligence, compliance checks, and background verification as required. I acknowledge that submission of this application does not guarantee approval and is subject to formal review.

Authorized Signatory Name:

Signature: *

No file chosen

Title:

Date:

Company Seal (if applicable):