Small Business Lending Small Business Capital LLC an SBA Authorized Direct Lender LOAN APPLICATION

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1 Small Business Lending Small Business Capital LLC an SBA Authorized Direct Lender 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 loan application. Please don t hesitate to contact us, should you have any questions. THE FOLLOWING FORMS HAVE BEEN PROVIDED: 1. Loan Request Form 2. Personal Financial Statement: Complete on all owners, partners, officers, directors, key employees, guarantors, and stockholders with 20% or more of ownership or stock issued. (Must include husband and wife even if one has nothing to do with the business) 3. Management Resume(s): Provide complete resumes on all individuals referred to in #2 above. (Resume should detail any and all related experience within the industry) IN ADDITION, PLEASE PROVIDE THE FOLLOWING ITEMS: 4. Business Debt Schedule: This schedule must be dated the same as the Interim Financial Statement requested below and reflect all outstanding liabilities as shown on the interim financial statement. 5. Business Complete FEDERAL Tax Returns with all schedules: Tax returns for the three most current years on the business to be financed. 6. Interim Business Financial Statement: Income statement and balance sheet dated no older than 60 days on the business to be financed. 7. Personal Complete FEDERAL Tax Returns: Tax returns for the past three years on each individual referred to in #2 above. 8. Affiliate Company Tax Returns: Complete federal tax returns for the past three years for any company in which any key principal in #2 above has a 20% or more interest. 9. Other:

2 LOAN REQUEST FORM Business Name: Street Address: City, State & ZIP: Telephone #: Fax #: Key Contact: Address: Web Address: Date Established: Number of Employees at Present: Title: After Loan: Type of Entity: Corporation Partnership Sole Proprietor Business Bank: Bank Address: USE OF PROCEEDS Land and/or Building Acquisition $ New Building Construction/Take Out $ Leasehold Improvements, Expansion Repair $ Acquisition of Machinery & Equipment $ Business Acquisition $ Inventory Purchase $ Working Capital (Including Accounts Payable) $ Pay off Bank Debt (Non SBA) $ Pay off Other Debt (Non SBA) $ Other: $ Total Estimated Project Cost $ Minus own funds to be used in project - $ ( ) Minus other financing sources - $ ( ) Total Loan Request $

3 Personal Financial Statement 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. Date: Name: Residence Phone: ( ) Residence Address: Fax Phone: ( ) City, State, & Zip Code: Address: Business Name of Applicant/Borrower Business Phone: ( ) ASSETS LIABILITIES Cash on hands & in Bank $ Savings Accounts $ IRA or Other Retirement Account $ Accounts & Notes Receivable $ Life Insurance Cash Surrender Value Only... $ (Complete Section 8) Stocks and Bonds $ (Describe in Section 3) Real Estate $ (Describe in Section 4) Automobile Present Value $ Other Personal Property $ (Describe in Section 5) Other Assets $ (Describe in Section 5) Section 1: Source of Income Total... $ Salary $ Net Investment Income $ Real Estate Income $ Other Income (Describe below)* $ Description of Other Income in Section 1 Accounts Payable $ Notes Payable to Banks and Others $ (Describe in Section 2) Installment Account (Auto) $ Mo. Payments $ Installment Account (Other) $ Mo. Payments $ Loan on Life Insurance $ Mortgages on Real Estate $ (Describe in Section 4) Unpaid Taxes $ (Describe in Section 6) Other Liabilities $ (Describe in Section 7) Total Liabilities $ Net Worth $ Total.. $ Contingent Liabilities As Endorser of Co-Maker Salary $ Legal Claims & Judgments $ Provision for Federal Income Tax $ Other Special Debt $ *Alimony or child support payments need not be disclosed in Other Income unless it is desired to have such payments counted toward total income. Section 2: Notes Payable to Bank and Others (Use attachments if necessary. Each attachment must be identified as a part of this statement and signed. Original Current Payment Frequency How Secured or Endorsed Name and Address of Noteholder(s) Balance Balance Amount (Monthly, etc.) Type of Collateral Section 3: Stocks and Bonds (Use attachments if necessary. Each attachment must be identified as a part of this statement and signed). Market Value Date of Number of Shares Name of Security Cost Quotation/Exchange Quotation/Exchange Total Value

4 Section 4: Real Estate Owned (List each parcel separately. Use attachments if necessary. Each attachment must be identified as a part of this statement and signed). Property A Property B Property C Type of Property Name title holder & Address of Property Date Purchased Original Cost Present Market Value Name & Address of Mortgage Holder Mortgage Account Number Mortgage Balance Amount of Payment per Month/Year Status of Mortgage Section 5: Other Personal Property and Other Assets (Describe, and if any is pledged as security, state name and address of lien holder, amount of lien, term of payment, and if delinquent, describe delinquency.) Section 6: Unpaid Taxes (Describe in detail, as to type, to whom payable, when due, amount, and to what property, if any, a tax 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 creditworthiness. I certify the above 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: Social Security Number: Signature: Date: Social Security Number:

5 MANAGEMENT RESUME Please complete all sections, using full first, middle, and maiden names no initials. If an item is not applicable, indicate. You may include additional relevant information on a separate exhibit. Duplicate form as needed. PERSONAL INFORMATION First Name Middle Name Maiden Name Last Name Social Security Number Date of Birth Place of Birth U.S. Citizen? If No, Alien Reg. # Residence Phone Business Phone ( ) ( ) Residence Address City State Zip How Long? Previous Address City State Zip How Long? Spouse s First Name Spouse s Middle Name Spouse s Maiden Name Spouse s Last Name Spouse s Social Security # Date of Birth Place of Birth U.S. Citizen? If No, Alien Reg. # Are you employed by the U.S.? If Yes, What Agency / Position? Government? Have you ever been convicted, charged with or arrested for any criminal offense other than a minor motor vehicle violation? Have you or any officers of your company ever been involved in bankruptcy or insolvency proceedings? Are you or your business involved in any pending or prior lawsuits? If you answered yes to any of the above, please furnish details in separate exhibit. EDUCATION College or Technical Training Institution Name and Location Dates Attended From/To Major Degree or Certificate MILITARY SERVICE BACKGROUND Branch From To Honorable Discharge? Yes Rank at Discharge Major Assignment / Accomplishment No WORK EPERIENCE - List chronologically, beginning with present employment 1) Company Name/Location From To Title 2) Company Name/Location From To Title 3) Company Name/Location From To Title