Community Advantage Lender Participation Application

1. Identify lender’s type of organization:

2. Does the Organization have an executed Loan Guaranty Agreement SBA Form 750, making it eligible to participate in SBA’s 7(a) loan program?

3. Has the Organization been in business for less than 12 consecutive months?

4. Is the Organization regulated by a Federal financial regulator?

Organizations are eligible to apply for the CA Pilot Program if they are an SBA-CDC, SBA-Micro-lender, CDFI, or SBA ILP Lender and answered “No” to questions 2, 3, and 4.

Applicant Name

Business Address

Contact Person and Title

Business Email Addresses

What is the Organization’s Employer Identification Number?

What date was the Organization established?

Is Organization regulated by a State Agency?

Name of State Regulator (if applicable):

Are you interested in selling your Community Advantage loans into the Secondary Market?

1. IRS Tax Exempt Certification.

2. Certificate of Good Standing from the applicable Secretary of State.

3. Opinion of independent counsel that the lender is in compliance with applicable Federal, State and local laws in the formation and organization of the Lender.

4. List of officers and directors. For each individual listed include a resume and “Statement of Personal History,” SBA Form 1081, signed and dated within 90 days of submission to SBA. Any officer or director who answers “yes” to question numbers 10a, 10b, 10c or 11 on SBA Form 1081 must also submit fingerprint-cards.

5. List of key personnel (current and proposed) – including those who will be involved in loan packaging, processing, closing, disbursing, servicing and liquidating the lender’s CA loans. For each individual listed include a resume and SBA Form 1081 signed and dated within 90 days of submission to SBA. Any key employee who answers “yes” to question number 10a, 10b, 10c, or 11 on SBA Form 1081 must also submit finger-print cards.

6. Certified copy of a Resolution of the Board of Directors authorizing submission of application.

7. If a CDFI, a copy of most recent certification from the US Treasury, CDFI Fund.

1. A business plan including an organization chart and a description of current small business lending activities and the nature of proposed operations for CA Pilot Program including small business lending, Management & Technical Assistance, and demographic and economic information in area of operations.

2. Year-end audited financial statements for the last two years.* Interim financial statements for period not covered by audited financial statements.

3. Schedule of sources of funding and funds available.

4. Loan Performance History for last two years, including current delinquency, default and loss rates for the applicant’s entire small business loan portfolio.

5. Schedule and reconciliation of loan loss reserve and description of allowance for loan loss reserve methodologies.

6. Copy of lending policies and procedures governing business loan origination, servicing and liquidation.

7. A narrative describing the training and technical assistance program your organization delivers and how your organization determines a small businesses training and technical assistance needs.

8. Any other information the lender considers relevant for SBA to consider in evaluating the application.

* Not required if already submitted to SBA as part of SBA’s 504, Microloan, or ILP programs.

Authorized Representative: The undersigned is an authorized representative of the Organization submitting an application to participate in the CA Pilot Program.

Organization: The undersigned certifies that the Organization has filed articles of incorporation and by-laws with either the SBA or the CDFI Fund in connection with their participation in the 504, Microloan, ILP, and/or CDFI programs and that those organizing documents submitted have not materially changed. Alternatively, if material changes have occurred, the undersigned certifies that a copy of the current articles of incorporation and/or by-laws is included with this application.

State Regulation: The undersigned certifies that the Organization is not subject to regulation by a state financial regulator. Alternatively, if the Organization is subject to state regulation, the undersigned certifies that the Organization is in good standing with the State regulator and provides the following information to SBA with this application:

• Copy of the State statute or regulations governing the Organization’s operations
• Copy of the latest report of examination of Organization
• Description of State prescribed capital requirements and a certification that the Organization meets the established capital requirements.

Additional Information: The undersigned gives SBA permission to obtain any additional information necessary regarding the Organization’s relationship with creditors, other federal agencies, or other entities as necessary to evaluate the application.

Correct Information: The undersigned also certifies that the information provided has been accurately prepared on behalf of the Organization and that the information is true and correct, to the best of his or her knowledge, and that due diligence has been exercised to obtain true and correct information. The undersigned realizes that the penalty for knowingly making a false statement is a fine up to $250,000 and/or jail for up to five years under 18 USC 1001, and subject to other penalties as provided by law.