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Paycheck Protection Program Loan Application

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Personal Loan Application

Revised: August 2019    Platinum Bank NMLS #673646

Page 1 of 5

Personal Information

Are you applying jointly for this loan? Yes No    Initials

Full Name of Applicant #1:

Social Security Number:    Date of Birth:

Physical Address:

City State Zip Code

Mailing Address (if difference from above):

City State Zip Code

Previous Address (if at current address less than 2 years):

Home Phone Cell Phone Fax

E-Mail Address:

Driver’s License or State ID #:

State Issued Date Issued Expiration Date

Occupation (please be specific):

Employer’s Name Title

Address City Zip Code

Phone Number Years There

Name of nearest relative not living with you:

Address Phone Number

Check appropriate box: I am an American Citizen a Resident Alien a Non-Resident Alien

Are you currently or have you been a Senior Foreign Political Figure? Yes No

Do you have an immediate family member or close associate who is a current or former Senior Foreign Political Figure? Yes No

Joint Account Information (if Applicable)

Are you applying jointly for this loan? Yes No    Initials

Full Name of Applicant #1:

Social Security Number:    Date of Birth:

Page 2 of 5

Please Answer the Following Questions for all Applicants

Applicant #1 Applicant #2
Have you had a checking account in the last 12 Months? Yes No Yes No
If yes, where?
Have you had a checking account closed without your consent in the past 12 months? Yes No Yes No
Have you been convicted of a criminal offense involving the use of a check within the past 2 years? Yes No Yes No
Are there any State or Federal Tax Liens filed against you or any of your property? Yes No Yes No
Have you ever declared bankruptcy or defaulted on any debts? Yes No Yes No

Personal Loan Request

Type of Loan Requested: Home Equity Loan HELOC Auto Other

Amount Requested of Bank:    Cash Contribution on your Behalf:

Purpose/ Reason for Request:

Gross Monthly Income:

Source of Other Income:

Other Income:

Maximum Monthly Payment:    Desired Term:

Proposed Collateral:

Appraised Value (if Known):    Date Appraised:

Insurance Company:

Agent’s Name & Contact Information:

Are you party to any lawsuit? Yes No (If Yes, Please explain):

Attorney Name & Contact Information:

Applicant Marital Status:

Married

Separated

Unmarried (single, divorced, widowed)

Co-Applicant Marital Status:

Married

Separated

Unmarried (single, divorced, widowed)

Personal Assets / Debts

Assets: Value: Debts: Monthly Payment:

Other Obligations (Child Support, alimony, separate maintenance, tuition, etc.):

If applying for credit jointly, it is a requirement that all parties have completed page 1 as completely as possible. If a party, who is not an applicant, is required to sign to grant collateral, we will need that person’s name; however, they are not required to complete page 1.

Page 3 of 5

Other Information (Please Describe)

Thank you for considering Platinum Bank for your financing needs

BY SIGNING BELOW, YOU ACKNOWLEDGE AND AGREE TO EACH OF THE FOLLOWING

1. All information in this application and in the financial statements are true and complete to the best of your knowledge and belief.

2. That neither applicant has made any misrepresentation in this application or has failed to include important information.

3. Platinum Bank has the right to verify the accuracy of the information provided.

4. Platinum Bank is authorized to obtain a consumer credit report/ check the credit rating and history of all the applicant(s).

5. That all supporting documentation included in the application remains the property of Platinum Bank

6. That all information provided will be kept confidential by Platinum Bank and will be used only for the purposes of considering this loan request.

7. In the event we grant credit, Platinum Bank reserves the right to release information concerning our credit experience with the applicant.

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT

To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license and other identifying documents.

Applicant #1

Name: Date:

Signature:

Applicant #2

Name: Date:

Signature:

If you are not in the presence of a Platinum Bank representative, the account application applicant signature(s) must be notarized

STATE OF )

) SS

COUNTY OF )

Subscribed and sworn to before me this day of , 20.

_________________________________________

Notary Public for the State of

(SEAL) Residing at

My commission expires

Page 4 of 5

Stop Here! Only complete the section below if the loan is for:

• Home Improvement

• Home Purchase

• Refinance where both existing & new loan are secured by lien on dwelling.

The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are being fulfilled. For residential mortgage lending, Federal law requires that we ask applicants for their demographic information (e.g. ethnicity, race and sex) in order to monitor our compliance with equal credit opportunity, fair housing and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so.

APPLICANT

ETHNICITY

Hispanic or Latino

Mexican

Puerto Rican

Cuban

Other Hispanic or Latino

Print origin below:

Not Hispanic or Latino

I do not wish to provide this information.

RACE

American Indian or Alaska Native

Print name of enrolled or principal tribe.

Asian

Asian Indian

Chinese

Filipino

Japanese

Korean

Vietnamese

Other Asian

Print Race:

Black or African American

CO-APPLICANT

ETHNICITY

Hispanic or Latino

Mexican

Puerto Rican

Cuban

Other Hispanic or Latino

Print origin below:

Not Hispanic or Latino

I do not wish to provide this information.

RACE

American Indian or Alaska Native

Print name of enrolled or principal tribe.

Asian

Asian Indian

Chinese

Filipino

Japanese

Korean

Vietnamese

Other Asian

Print Race:

Black or African American

Page 5 of 5

APPLICANT

Native Hawaiian or Other Pacific Islander

Native Hawaiian

Guamanian or Chamorro

Samoan

Other Pacific Islander

Print Race (e.g. Fijian, Tongon, etc.)

White

I do not wish to provide this information.

SEX

Female

Male

I do not wish to provide this information.

CO-APPLICANT

Native Hawaiian or Other Pacific Islander

Native Hawaiian

Guamanian or Chamorro

Samoan

Other Pacific Islander

Print Race (e.g. Fijian, Tongon, etc.)

White

I do not wish to provide this information.

SEX

Female

Male

I do not wish to provide this information.

To Be Completed by Financial Institution (for an application taken in person):

YES NO
Was the ethnicity of the APPLICANT collected on the basis of visual observation or surname?
Was the ethnicity of the CO-APPLICANT collected on the basis of visual observation or surname?
Was the race of the APPLICANT collected on the basis of visual observation or surname?
Was the race of the CO-APPLICANT collected on the basis of visual observation or surname?
Was the sex of the APPLICANT collected on the basis of visual observation or surname?
Was the sex of the CO-APPLICANT collected on the basis of visual observation or surname?

This Section is to be completed by Interviewer Only:

This application was taken by: Face-to-Face Mail Telephone Internet

Interviewer’s Name (Print or Type):

Interviewer’s Signature:    Date:

Interviewer’s Phone Number (Include area code):

Name and Address of Interviewer’s Employer:

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What the Paycheck Protection Program Loan Application Is

The Paycheck Protection Program Loan Application is the borrower-facing form used to request a PPP loan from an SBA-approved lender and to document eligibility, payroll calculations, and certifications required for loan forgiveness consideration. The application collects business identity, employment and payroll data, requested loan amount, and borrower attestations about use of proceeds. Lenders use the completed application plus supporting payroll and tax records to underwrite the loan and, if applicable, to process forgiveness. Although the program’s original rounds have closed at times, many lenders still accept residual applications and forgiveness submissions under SBA guidance.

Why a Complete Application Matters

A complete, accurate PPP Loan Application is essential to secure funds and maximize the chance that the loan will be forgiven. It documents payroll calculations, allowable uses, and certifications that lenders and the SBA review when approving forgiveness and detecting ineligible claims.

Why a Complete Application Matters

Who Typically Prepares and Signs This Application

The application is completed by a business owner, authorized officer, or an authorized representative such as a CPA or payroll provider.

  • Small business owners and sole proprietors who seek payroll coverage and working capital assistance.
  • Nonprofit organizations and veterans’ groups that meet SBA size and eligibility rules.
  • Accounting firms or payroll vendors preparing payroll calculations and supporting documentation.

The signer should be someone with authority to certify payroll figures and attest to the borrower certifications; lenders will verify authority and supporting records.

Step-by-step: Submitting a PPP Loan Application

A concise four-step process helps ensure accuracy and speed from preparation to submission.

  • 01
    Gather Documents: Collect payroll records, tax forms, bank statements and government IDs.
  • 02
    Complete Application: Fill fields, calculate payroll, and enter exact dollar figures.
  • 03
    Attach Support: Upload supporting payroll and tax documentation in PDF format.
  • 04
    Submit to Lender: Send via lender portal or secure eSubmission and retain confirmations.

Recommended Digital Workflow Settings for eSubmission

Configure your document workflow to reduce friction, improve auditability, and preserve records for compliance.

Field Recommended Setting
Authentication Email plus SMS code
File Format PDF/A preferred for long-term retention
Signature Type Electronic signature with audit trail
Record Retention Retain signed file and audit log

Digital Submission and Platform Requirements

Use a secure eSignature-capable platform that supports PDF uploads, audit trails, and signer authentication to submit PPP applications.

  • Integrations: CRM and payroll integrations reduce manual entry
  • File formats: PDF, DOCX accepted; PDF preferred
  • Authentication: Email verification and optional 2FA

Verify the platform’s encryption, audit log, and retention capabilities before submitting; lenders commonly require retained copies of signed applications and supporting documentation.

Typical eSubmission Flow for a PPP Application

The following high-level steps show how a digital submission generally proceeds from sender to lender.

  • Upload Document: Sender uploads completed application and attachments
  • Prepare Fields: Place signature, date, and data fields
  • Authorize Signer: Signer authenticates and signs electronically
  • Track & Archive: Platform logs events and stores final documents

Essential Components of a Professional PPP Loan Application Package

A lender-grade package includes identity, payroll detail, certifications, and clear authorizations to allow timely underwriting and later forgiveness review.

Borrower Identity

Legal business name, DBA, EIN or SSN, business address, and contact details for the authorized signer to establish legal identity and lender correspondence.

Payroll Documentation

Payroll records, paystubs, IRS Form 941, state unemployment filings, and bank statements that support the payroll totals used to calculate the loan amount.

Loan Calculation

Clear worksheet showing the formula and period used to compute average monthly payroll and the resulting requested loan amount for lender verification.

Certifications

Borrower certifications about use of proceeds, eligibility, and the accuracy of payroll data that the signer must attest to under penalty of law.

Lender Attestation

Space for lender review fields, loan number, and underwriting notes required for recordkeeping and SBA review if audited.

Authorization to Release

A signed authorization permitting the borrower or payroll provider to share payroll records and supporting documents with the lender for verification.

Security and Compliance Essentials for Electronic Submission

Encryption: TLS 1.2/1.3 in transit; AES-256 at rest
Audit Trail: Detailed signing history and timestamps
Access Controls: Role-based access and SSO support
Regulatory Compliance: Meets ESIGN and UETA requirements
HIPAA Support: BAA available where required
Retention: Secure storage with export capabilities

Penalties and Risks of an Incorrect Application

False Statements: Criminal and civil penalties for knowingly false certifications
Forgiveness Denial: Loan forgiveness may be reduced or denied
Repayment Requirement: Lender may demand immediate repayment for ineligible use
Audit Exposure: SBA audit can trigger additional documentation requests
Delays: Incomplete forms slow funding and forgiveness review
Tax Consequences: Misreported payroll affects tax filings and credits

Common Preparation Pitfalls to Avoid

  • Using handwritten, unclear payroll summaries that do not match tax forms leads to lender rejection and rework.
  • Failing to document the payroll period or mixing personal and business expenses that obscure eligible payroll costs.
  • Submitting mismatched names or EINs that prevent identity verification and delay processing.
  • Relying on informal estimates instead of precise calculations and supporting source documents for each payroll entry.

Timing and Deadlines to Track for PPP Applications and Forgiveness

Timely submission and recordkeeping affect loan funding, forgiveness eligibility, and payment obligations; confirm current lender and SBA guidance for any open application windows.

Application Window:

Submit when the lender’s portal is accepting PPP applications; availability varies by lender.

Forgiveness Submission:

Submit forgiveness documentation to your lender within the period specified in SBA guidance to avoid payment deferrals.

Record Retention:

Keep payroll and application records for the full retention period required by regulators.

Correction Timeframes:

Provide requested supplemental documents promptly to prevent processing delays.

Loan Payment Start:

If forgiveness not granted, payments typically begin per lender schedule after covered period and deferment end.

eSignature Vendor Pricing Snapshot for PPP Application eSubmission

Common plan and feature comparisons help decide which eSignature vendor aligns with your submission, security, and volume needs. Prices shown reflect typical per-user or per-signature models used in the market.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies by plan Varies by plan Varies by plan Varies by plan
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No cap 100 envelopes/user/year Varies Varies Varies

Examples: How Different Organizations Submit PPP Applications

Two real-world scenarios illustrate practical documentation choices and outcomes for PPP submissions.

Optica Ventures LLC

A small services firm consolidated three months of payroll statements and bank deposits

  • Lender accepted the clear worksheet
  • The firm preserved originals and provided PDFs to expedite forgiveness review and auditing.

Fertility Centers of Illinois

A healthcare practice used a BAA-covered eSignature workflow to share staff payroll records

  • They redacted PHI where unnecessary
  • This reduced signer friction while keeping compliance documentation intact for audits.

Practical Tips for Accurate, Efficient PPP Application Completion

Follow these practices to reduce errors, speed lender review, and improve the likelihood of accurate forgiveness calculation.

Document Source Files
Attach original payroll registers, tax filings, and bank statements rather than summaries so lenders can reconcile totals quickly.
Use Clear Calculations
Provide step-by-step worksheets showing formulas used and period selection to prevent misinterpretation.
Confirm Signer Authority
Ensure the signer has corporate authority and can certify payroll accuracy to avoid later challenges.
Preserve Audit Trail
Retain electronic audit logs showing timestamps, IP addresses, and signer authentication events for 3–7 years.

Frequently Asked Questions About the PPP Loan Application

Answers to common questions about signing, supporting documents, corrections, and signer authority for PPP applications.


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