sba questionnaires
SBA 7(a) and SBA 504 Loan Request Summary
Contact for Applicant:
Name
_________________________________________________Title __________________ Date _________
Address: ____________________________________________________________________________________
Phone #: ______________________ Fax #: _____________________ Cell # _____________________________
Established Date: ________________
Tax ID #: __________________________
ABOUT YOUR BUSINESS:
1. Business’ Legal name: ________________________________________________
2. How many employees does your business have? Before the loan ______ After the loan ______
3. Has the applicant or any owner of 20% or more of the company ever defaulted or is currently in arrears on a government debt or student loan?
4. Is the business a franchise?
If yes, please provide a copy of the franchise agreement and franchise offering circular.
Yes
No
Yes
No
5. Ownership Information: Please complete all columns for all owners of the company.
Ownership must total 100%.
Full Name
Title
%
U.S.
Citizen
**
SSN
Gender*
Race*
Military Service*
To / From
*This data is collected for statistical purposes only. It has no bearing on the credit decision. Disclosure is voluntary. One or more boxes for race may be selected.
**
If not a US Citizen, provide USCIS (INS) documentation of Residency Status
6. For all owners of 20% or more please complete the “owner or management resume” template attached:
7. Is any principal or manager of the business currently subject to an indictment, criminal information, arraignment, or other means by which formal criminal charges are brought in any jurisdiction?
Yes
No
8. Has any principal or manager of the business been arrested in the past six months for any criminal offense?
Yes
No
9. Has any principal or manager of the business ever been convicted, plead guilty, plead nolo contendere, place on pretrial diversion or on any form of
Contact for Applicant:
Name
_________________________________________________Title __________________ Date _________
Address: ____________________________________________________________________________________
Phone #: ______________________ Fax #: _____________________ Cell # _____________________________
Established Date: ________________
Tax ID #: __________________________
ABOUT YOUR BUSINESS:
1. Business’ Legal name: ________________________________________________
2. How many employees does your business have? Before the loan ______ After the loan ______
3. Has the applicant or any owner of 20% or more of the company ever defaulted or is currently in arrears on a government debt or student loan?
4. Is the business a franchise?
If yes, please provide a copy of the franchise agreement and franchise offering circular.
Yes
No
Yes
No
5. Ownership Information: Please complete all columns for all owners of the company.
Ownership must total 100%.
Full Name
Title
%
U.S.
Citizen
**
SSN
Gender*
Race*
Military Service*
To / From
*This data is collected for statistical purposes only. It has no bearing on the credit decision. Disclosure is voluntary. One or more boxes for race may be selected.
**
If not a US Citizen, provide USCIS (INS) documentation of Residency Status
6. For all owners of 20% or more please complete the “owner or management resume” template attached:
7. Is any principal or manager of the business currently subject to an indictment, criminal information, arraignment, or other means by which formal criminal charges are brought in any jurisdiction?
Yes
No
8. Has any principal or manager of the business been arrested in the past six months for any criminal offense?
Yes
No
9. Has any principal or manager of the business ever been convicted, plead guilty, plead nolo contendere, place on pretrial diversion or on any form of