Small Business Administration Loan Information Form

The following worksheets are a brief outline of the important information that will be requested when you begin to complete a SBA Loan Application. If you wish, you may use this sheet as a guide and a worksheet to help gather the information needed. This information will also be discussed when we meet to discuss your specific needs. If you have any questions on these items or are ready to review the full application, please feel free to call us at (877) 508-2274.

Introduction:

The following are the primary categories that we try to fully understand from the information that will be provided during the application process for an SBA Loan. Please read through these categories and be sure that these areas are thoroughly addressed in your business plan or in the application.

Management Quality and Experience - Experience of the borrowers is one of the most important ingredients of a successful business. Please make sure that in your information, you highlight the experience and skill required to successfully manage your business. This information is best described and highlighted in the following pages of the SBA Loan Application:

· Management Resume

Cash Flow - Cash Flow is an important subject to determine right from the beginning. Cash flow calculations help to determine the ability to pay expenses, debt service, and derive profits. Cash flow is determined from the following sources of information:

· Projected Income Statements (2 years) · Assumptions to Projections · Historic Income Statements (3 years)

· 3 Years Tax Returns (Pers. & Bus.) · Historic Balance Sheets (3 years)

Collateral - SBA Loans should be fully collateralized. This is best described and highlighted from the following sources of information:

· Personal Financial Statement · Estimated Project Costs

· Business Financial Statements · Business Plan, required for all start ups

Capital -This represents your investment in your business as it applies to this loan. SBA Loans require cash investment from the borrowers ranging from 10% to 30% on the purchase of business assets depending on the type and structure of the project. This is best described and highlighted from the following sources of information:

· Personal Financial Statement · Estimated Project Costs · Capital Injection Worksheet

· Business Financial Statements · Business Plan, required for all start ups

Business/Market Conditions - Take time to communicate the market position of your business and business conditions. This is best described and highlighted from the following sources of information:

· History of Business · Marketing Plan

· Business Plan, required for all start ups

SBA Loan Application Checklist (Complete list of items needed for your SBA loan package)

Quick Pre-Qualification Checklist
of Forms and Information

The following is a list of items needed to provide a quick pre-qualification of your request.

1. Forms Included In Application Package

___Loan Request Form

___Personal Financial Statement

___Statement of Personal History complete and sign

___Authorization to Release Information –

___Business Debt Schedule

___Management Resume for all principle owners

___Personal Family Budget

___History Of Business

2. Additional items to provide for pre-qualification

___Business Financial Statements-

___Income Statements & Balance Sheets (3 years)

___Interim Business Income Statement and Balance Sheet.

(45 days or newer)

___Cash Flow Projections – 2 Year Pro-Forma (Projections)

___Assumptions to Projections

___Business Tax Returns - Business Tax Returns (3 years)

___Personal Tax Returns - & W-2’s (3 years)

___List of Equipment to be purchased

___Construction Costs if applicable

___Business Plan, required for all start ups

Please email/fax/mail the above application to us for review.

Diamond Financial Services

262 Highway 36

West Keansburg, NJ 07734

732-495-7058 (fax)

Donj@easysba.com

A representative from our company will contact you by phone/email with any additional questions that we may have.

We will then complete your package and mail to you for original signatures. At that time you will be requested to return all additional information needed on the check list to complete your loan package.

Note: This list includes the majority of items needed for a complete SBA Loan Application. There are usually, however, additional items that become necessary during the approval process. Feel free to ask questions about any of these items listed.

Additional Items Needed to Complete the Loan File

The following is a list of additional items needed to complete the full SBA Loan Request File.

1. SBA Application Package

___Insurance Information

___Request for Copy of Transcript Tax Form

2. Business Financial Information

___Aging of Receivables/Payables

___Financials on Affiliate Businesses

3. Personal Financial Information

___Personal Tax Returns- & W-2’s (3 years)

___Personal Financial Statements – from all owners (45 days or

newer)

___Copy of Mortgage Statements on all property

___Proof of Cash Injection required by borrower

4. Use of Funds Information

___Specific Breakdown of the Use of Funds

5. Other Items

___Articles of Organization

___Operating Agreement

___Partnership Agreement

___Fictitious Business Name Statement (or equivalent)

___Business License

___Articles of Incorporation & Bylaws

___Trust Agreements if applicable

___Escrow Instructions

___Leases or Proposed Lease

___Driver’s License for all owners/borrowers

___Green Card if applicable

___Environmental Questionnaire if applicable

___Employer Tax ID Number

___Corporate Stock Certificates

___Certificate of Secretary

___Certificate of Member or Partner

___Landlord’s Consent on leased property

___Assignment of Lease from Landlord

___Franchise Agreements

___Builder Information

___Plans and Drawings

___Estimates and Bids

___Permits if available

6. Items gathered by Lender

___Dun & Bradstreet Business Report

___UCC Search

___Credit Report on all owners

___Preliminary Title Report

___Flood Zone Report

___Environmental Phase I if applicable

___Appraisals if applicable

___Site visit analysis

7. Other Items needed

Small Business Administration Loan Application Form

Amount of Loan Requested	Term: # of Years (requested):
(See Estimated Project Costs Below for Requested Loan Amount)
Applicant Company Information

Borrower Name:	Current Address:
Trade Name:
Type of Business:	Future Address:
Business Phone:
Fax Number:	Rent or Own:		Rent Own
		Contact Person:
		Contact Phone:

Are you presently under indictment, on parole or on probation?	Yes No
If yes, please explain:
Have you ever been charged with, arrested, and/or convicted of any criminal offense other than a minor motor vehicle violation?		Yes No
If yes, please explain in detail, sign and attach to the “Statement of Personal History” form in application!

Borrowing Entity: Corporation:	Partnership		Limited Partnership
Sole Proprietorship	LLC		Other
Number of existing employees		# of employees after this loan

Estimated Project Costs

Costs/Uses of Funds - Please outline the use of funds in the space below. Be as specific as possible.

	TOTAL COSTS	COMMENTS
Land and Building (total costs)	$
New construction	$
Leasehold improvements	$
Machinery & equipment	$
Debt repayment	$
Inventory	$
Working capital	$
Fees	$
Other	$
Total Project	$ 0
Seller Financing	$ 0
Cash Injection	$
TOTAL LOAN REQUEST	$ 0

Ownership of Applicant Company

(Show 100% of ownership including all proprietors, partners, officers, directors and any holders of outstanding stock)

Name/Title	% Owned	Compensation	Active?	Citizen?	Green Card?
	%
	%
	%
	%
	%

Sources of Applicants Capital Injection and/or Equity

When purchasing Real Estate, Equipment, or other assets; between 10% to 30% or more may be required as cash injection toward the purchase. Please list the location of the funds to be used as capital / cash injection.

Amount	Where Funds are held or Source of Equity Injection
$
$
$

Collateral For This Loan

Please list the collateral that will be offered for this loan.

Estimated Value of Collateral

Source of Valuation

Additional Information

Do any of the principals of the business have any ownership in other businesses? If yes, list all ownership under Affiliates section.	Yes No
Have any of the principals been arrested and/or convicted of a Felony or Misdemeanor, on parole or probation, or under Indictment? If yes, explain.	Yes No
Are any applicants a party to past or pending claims, lawsuit, judgement, or tax liens? If yes, attach full description.	Yes No
Have you ever applied or obtained an SBA Loan or assistance from SBA before? If yes, please state current status below.	Yes No
Status ( Loan Amount, Current Balance, Collateral):

Has any applicant filed Bankruptcy in past?	Yes No	If yes, attach full description.
Do applicants owe any past Taxes?	Yes No	If yes, attach full description.
Have you prepared a Business Plan?	Yes No	If yes, please attach
Have you completed cash flow projections?	Yes No	Please attach
List Important Trade References: 1		Phone
2		Phone

Bank Reference	Phone
Accountant Name	Phone
Attorney Name	Phone

Affiliates

List below all business concerns in which the Applicant Company or any of the individuals listed in the ownership section above have 20% or more ownership.

Company Name	Name, Type of Ownership	% of Ownership
		%
		%
		%
		%

Brief Description of the Primary Purpose for This Loan

Please provide a brief description of your Business and the primary need and use for SBA Loan Funds.

Attach Financial Information Here

Historic Business Financial Statements - This should include 3 years of: (Check All Attached)
	Business Income Statements (often called a Profit and Loss Statement)
	Business Balance Sheets (Assets and Liabilities on the Business)
	Business Tax Returns

Interim (Current) Business Financial Statement – Profit & Loss Statement and Balance Sheet
	The most current Business Income Statement and Balance Sheet – dated 45 days or newer. Include with the Interim statement, an Accounts Receivable Aging and an Accounts Payable Aging dated the same as the Interim financial Statement.

3 Years Historic Personal Tax Returns
	Personal Tax Returns

Pro-Forma (Projected) Business Financial Statement and Assumptions to Projections
	Prepare a projection of your Income (Profit and Loss) Statement for 2 years into the future.
	Prepare Assumptions to Projections.

Current Accounts Receivable and Accounts Payable Aging
	Must balance to and be dated the same as the Interim Financial Statements noted above.

I/We hereby acknowledge that the information contained in the SBA Loan Application Package, including all attachments and exhibits are true and accurate as of the stated date(s). I/We further acknowledge that the loan approval will be in writing and subject to the terms and conditions set forth in a commitment letter signed by an officer of the institutional SBA lender we apply to.

Signature:	Date:
Signature:	Date:

Personal Financial Statement

U.S. Small Business Administration	As of (date)
Complete this form for : (1) each proprietor, or (2) each limited partner who owns 20% or more interest and each general partner, or (3) each stockholder owning 20% or more of voting stock and each corporate officer and director, or (4) any other person or entity providing a guaranty on the loan.

Name	Spouse’s Name:
Business Phone:	Residence Phone:
Residence Address:
Business Name of Applicant/Borrower

Assets Liabilities

Cash in Banks	$		Accounts Payable Describe in Section 2	$
Savings in Banks	$		Notes Payable Describe in Section 2	$
IRA / Retirement	$		Installment Loans Describe in Section 2	$
Cash Value Of Life Insurance Complete Section 8	$		Other Loans Describe in Section 2	$
Stocks & Bonds Describe in Section 3	$		Real Est. Loans Describe in Section 4	$
Real Estate Owned Describe in Section 4	$		Other Liabilities Describe in Section 7	$
Automobile – Present Value	$		Unpaid Taxes Describe in Section 6	$
Other Assets & Property Describe in Section 5	$		Total Liabilities	$ 0
			Net Worth	$ 0
Total Assets	$ 0	Equals	Total	$ 0

Section 1

Salary	$
Net Investment Income	$
Real Estate Income	$
Other Income	$	Describe other income:

Section 2 Notes Payable to Bank and Others (use attachment A if necessary)

Name and address of Note Holder	Original Balance	Current Balance	Payment Amount	Frequency (Monthly, etc.)	How Secured or Endorsed Type of Collateral
	$	$	$
	$	$	$
	$	$	$
	$	$	$
	$	$	$
	$	$	$
	$	$	$
	$	$	$

Personal Financial Statement Page 2.

Section 3 Stocks and Bonds (use attachments if necessary)

Number of Shares	Name of securities	Cost	Market Value Quotation/Exch.	Date of Quote	Total Value
		$	$		$ 0
		$	$		$ 0
		$	$		$ 0
		$	$		$ 0

Section 4 Real Estate Owned (List Each Parcel Separately. Use attachments if necessary.)

	Property A	Property B	Property C
Type of Property
Address of Property
Name and address of Title Holder
Date Purchased
Original Cost	$	$	$
Present Market Value	$	$	$
Name and Address of Mortgage Holder
Mortgage Account Number
Mortgage Balance	$	$	$
Monthly Payment	$	$	$
Status of Mortgage

Section 5 Other Personal Property and Other Assets (describe, if any is pledged as security, state name and address of lien holder amount of lien, terms of payment, and if delinquent, describe delinquency)

Personal Property (Estimated value of home furnishing, appliances, electronics, jewelry, etc.)

Section 6 Unpaid Taxes (describe in detail, as to type, to whom payable, when due, amount and to what property if any, a lien attaches)

Section 7 Other Liabilities (describe in detail)

Section 8 Life insurance Held (give face amount and cash surrender value of policies – name of insurance company and beneficiaries).

I authorize SBA/Lender to make inquiries as necessary to verify the accuracy of the statements made and to determine my credit worthiness. I certify the information contained in the Personal Financial Statement and the statements contained in the attachments are true and accurate as of the stated date(s). These statements are made for the purpose of either obtaining a loan or guaranteeing a loan. I understand FALSE statements may result in forfeiture of benefits and possible prosecution by the U.S. Attorney General (reference 18 U.S.C 1001).

Signature	Date	SSN:
Signature	Date	SSN:

Please note: The estimated average burden hours for this completion of the form is 1.5 hours per response. If you have any question or comments concerning this estimated or any other aspect of this information, please contact Chief Administrative Branch US small Business administration, Washington DC 20416 and clearance office, Paper Reduction Project (3245-0188), Office of Management and Budget. Washington, DC 20503

Personal Family Budget (Personal Financial Statement Attachment)

INCOME	MONTHLY	Yearly
Gross Salary or Draw (projected with new business)	$	$ 0
Spousal Salary (projected with new business)	$	$ 0
Gross Rental Income	$	$ 0
Interest / Dividend Income	$	$ 0
Other Income	$	$ 0
Total Income	$ 0	$ 0

EXPENSES

Residence Payment (Mortgage or Rent)	$	$ 0
Rental Property Mortgage	$	$ 0
Rental Expenses (impounds, cash expenses)	$	$ 0
Auto Loan Payments (List all debts on Financial Statement)	$	$ 0
Installment Payments (List all debts on Financial Statement)	$	$ 0
Credit Card Payments (List all debts on Financial Statement)	$	$ 0
Utilities & Phone	$	$ 0
Insurance Payments	$	$ 0
Food, Clothing	$	$ 0
Income Tax	$	$ 0
Property Tax	$	$ 0
Alimony	$	$ 0
Child Care/Support	$	$ 0
Other	$	$ 0
Miscellaneous (10% of Monthly Income)	$	$ 0
Total Expenses	$ 0	$ 0
Net Discretionary Income	$ 0	$ 0

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

Signature