SBA Loan Application

SBA Loan Application

This checklist has been provided to assist you through the process of gathering the necessary information for the initial evaluation of your loan request. Complete information will be necessary to process your application. If you have any questions, please contact our SBA Department at the number below:

Please submit all forms in ink or typewritten. All financial statements and tax returns must have original signatures and dates.

Applicant Information Sheet

Applicant Business Name: Amount Requested:

Business Address:

Business Phone: Tax I.D. No.:

Is your business?

Existing

Start-Up

Franchise

What does your company do? How many years in business?

Number of employees at present: If loan is obtained:

Total Project Cost: Borrower Cash Injection: %:

Use of Proceeds (check all that apply)

Previous SBA Financing? Yes No Present Borrower? Yes No Repaid/Other Loan Number:

Affiliated businesses (20%+ ownership):

Bank of Business Account: Bank Address:

Name of Accountant: Phone: Name of Attorney: Phone:

Management (proprietor, partners, officers & directors) owning more than 20% interest in the company must complete.

Have you or any officer of your company ever been involved in bankruptcy or insolvency proceedings? If so, please provide the details.

Yes No

Are you or your business involved in any pending lawsuits? If yes, please provide the details.

Yes No

Do you or your spouse or any member of your household, or anyone who owns, manages, or directs your business or their spouses or members of their households work for the Small Business Administration, Small Business Advisory Council, SCORE or ACE, any federal agency, or the participating lender? If so, please provide the name and address of the person and office where employed.

Yes No

Name: Address:

Has the business or any of its principals ever been involved in a federal loan or federally assisted financing that defaulted and caused a loss to the Federal government or any of its Departments or agencies?

Yes No

Does your business presently engage in Export Trade?

Yes No

Do you have plans to begin exporting as a result of this loan? Would you like information on Exporting?

Yes No Would you like information on Exporting? Yes No

I/we hereby certify that the above information is valid and correct to the best of my/our knowledge.

Personal Financial Statement

Complete this form for each proprietor, limited partner, stockholder, or guarantor as applicable.

Name: Business Phone:

Residence Address: Residence Phone:

City, State, & Zip Code:

Business Name of Applicant/Borrower:

As of:

Assets and liabilities details:

Source of income / other income description:

Notes payable and obligations:

Real estate owned:

Life insurance held:

Signature of applicant(s):

Management Resume

Please fill in all spaces. If an item is not applicable, please indicate as such.

Name: SS#:

Date of Birth: Place of Birth:

Residence Telephone: Business Telephone:

Residence Address:

Previous Address:

Spouse's Name: SS#:

Are you employed by the U.S. Government? Yes No Agency/Position:

Are you a U.S. citizen? Yes No If no, alien registration number:

Education / Schools attended:

Military service background:

Work experience:

Business Debt Schedule

Company Name: Date:

History of Business

Use separate attachments to answer questions if necessary.

Nature of Business:

Types of Products / Services:

Customer Profile:

List Key Customers:

List Major Competitors:

Major past accomplishments:

Future plans for Growth / Expansion:

How will this loan benefit your company?

Will the funding of this loan create new employment opportunities? If so, state how:

Authorization to Release Information

I/We hereby authorize the release to Pacific Commerce Bank of any and all information including credit investigations they may require at any time for the purpose related to our credit transaction with them.

Request for Transcript of Tax Return

Taxpayer name: SSN/EIN:

Spouse name: Second SSN:

Current address:

Previous address:

Third party recipient (if any):

Transcript requested:

Return Transcript

Account Transcript

Record of Account

Verification of Nonfiling

W-2 / 1099 / 1098 / 5498 Transcript

Tax form number: Year(s) requested:

Signature of taxpayer(s):

Statement of Personal History

Name and Address of Applicant:

SBA District/Disaster Area Office:

Amount Applied For: File No.:

Personal statement of:

Percentage of ownership / stock owned:

Date of Birth:

Place of Birth:

U.S. Citizen? Yes No

If non-U.S. citizen, alien registration number:

Present residence address:

Home Telephone No.: Business Telephone No.:

Most recent prior address:

Question 7: Yes No

Question 8: Yes No

Question 9: Yes No

Question 10 authorization:

Signature: Title: Date:

Notices Required By Law

The following is a brief summary of the laws applicable to this solicitation of information.

Paperwork Reduction Act (44 U.S.C. Chapter 35)

Privacy Act (5 U.S.C. § 552a)

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