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. Prequalification Meeting 1. Personal 1040 Federal Tax Returns with all schedules for three years. Complete for all owners, partners, officers, directors, guarantors, and stockholders with 20 or more of total stock issued. 2. Business Federal Tax Returns with all schedules for three years. Include affiliate businesses if applicable. If latest return is on extension, we will need a copy of the extension and the prior three years of tax returns. 3. Business Schedule of Debts. (Form is enclosed within SBA application.) Include affiliate businesses if applicable. This schedule should include loans for contracts, notes, leases payable and lines of credit. Example would include cars, trucks, equipment, furniture, and computers. It should not include accounts payable and/or accrued liabilities. 4. Personal Financial Statement. (Form is enclosed within SBA application.) Complete for all owners, partners, officers, directors, guarantors, and stockholders with 20 or more of total stock issued. Must be signed by spouse even if not involved in business, per SBA requirements. 5. Latest Business Financial Statements available (Profit and loss with a balance sheet, current, not older than 90 days from date of application) 6. Authorization To Release Information. (Form is enclosed within SBA application. Must be signed by applicant and spouse--if spouse is to be on the loan.) EQUAL HOUSING LENDER EQUAL HOUSING LENDER FORM 03253 (Rev. 07/2009) eform Member FDIC 1 of 12
NOTICE TO BUSINESS APPLICANTS: EQUAL CREDIT OPPORTUNITY NOTIFICATION LETTER YOUR RIGHTS UNDER REGULATION "B", THE EQUAL CREDIT OPPORTUNITY ACT Dear Applicant: Thank you for applying to us for credit. If your application for credit is denied, you have the right to a written statement of the specific reason(s) for the denial. You will have sixty (60) days from the date on which you were notified to request that statement. We will send you a written statement of the reason(s) for the denial within thirty (30) days of receiving your request for the statement. To obtain the statement, please write to Union Bank, 18300 Von Karman Avenue, 1st Floor, Irvine, CA 92612, Attention: Credit Executive. Notice: The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status and age (provided the applicant has the capacity to enter into a binding contract), or because all or a portion of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The Federal Agency that administers compliance with this law concerning this creditor is: Comptroller of the Currency Customer Assistance Group 1301 McKinney Street, Suite 3450 Houston, Texas 77010-9050 FORM 03253 (Rev. 07/2009) eform 2 of 12
SBA LOAN REQUEST APPLICANT COMPANY Company Name Office Phone Address City State Zip Code Office Fax Email Address Cell Phone Type of Business Type of Entity: Date Established Corporation Partnership Sole Proprietorship LLC LLP Number of Employees: Existing Bank Name After This Loan Phone Bank Address Accountant Name Attorney Name Phone OWNERSHIP OF APPLICANT COMPANY List all officers, directors, partners, owners, co-owners, and all stockholders with 20 or more interest. NAME TITLE OF OWNERSHIP ANNUAL COMPENSATION AFFILIATES List all business concerns in which the applicant company, or any of the individuals listed in the ownership section above, own 20 or more. Also see page 11. COMPANY NAME OWNERSHIP (APPLICANT COMPANY INDIVIDUALS) OF OWNERSHIP Land and building acquisition* Building improvements or repairs Land acquisition* Acquisition of machinery/equipment Inventory purchase ESTIMATED PROJECT COST Working capital (including accounts payable) Acquisition of all or part of existing business Refinance debt Closing cost for SBA loan Total project cost * How do you wish to take title to Real Estate being purchased? Less cash injection Loan Amount FORM 03253 (Rev. 07/2009) eform 3 of 12
FOR BANK USE ONLY ORIGINATING OFFICE OFFICE NUMBER MAIL CODE FAX NUMBER RELATIONSHIP OFFICER NAME EMPLOYEE NUMBER DATE PHONE NUMBER ONSITE INSPECTION COMPLETED BY (Print Officer Name) SIGNATURE X DATE FORM 03253 (Rev. 07/2009) eform 4 of 12
PERSONAL FINANCIAL STATEMENT U.S. SMALL BUSINESS ADMINISTRATION As of 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 Residence Address Business Phone ( ) Residence Phone ( ) City, State, and Zip Code Business Name of Applicant/Borrower ASSETS (Omit Cents) LIABILITIES (Omit Cents) Cash on hand and in Banks Savings Accounts IRA or Other Retirement Account Accounts and 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)
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 Number of Securities Cost Quotation/Exchange Quotation/Exchange Total Value Section 4. Type of Property Name of Property Owner Address of Property Date of Purchased Original Cost Present Market Value Name and Real Estate Owned. (List each parcel separately. Use attachments if necessary. Each attachment must be identified as a part of this statement and signed.) Address of Mortgage Holder Mortgage Account Number Mortgage Balance Amount of Payment per Month/Year Status of Mortgage Monthly Rental Income Monthly Taxes and Insurance Property A Property B Property C 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, terms 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. 100). Signature: Date: Social Security Number: Signature: NOTE: Date: Social Security Number: The estimated average burden hours for the completion of this form is 1.5 hours per response. If you have questions or comments concerning this estimate or any other aspect of this information, please contact Chief Administrative Branch, U.S. Small Business Administration, Washington, D.C. 20416, and Clearance Office, Paper Reduction Project (3245-0188), Office of Management and Budget, Washington, D.C. 20503. FORM 03253 (Rev. 07/2009) eform 6 of 12
ACCOUNTS RECEIVABLE (A/R) AND ACCOUNTS PAYABLE (A/P) AGING SUMMARY A/R and A/P totals listed below must correspond to current business financial statement dated. Aging Current - 30 days 31-60 days 61-90 days Over 90 days Total Number of Accounts A/R Amounts # of total A/P Amounts # of total Accounts Receivable representing more than 20 Outstanding Balance Outstanding Balance Accounts Receivable of over 90 days Collectability Outstanding Balance Collectability Outstanding Balance Accounts Payable over 90 days Collectability Collectability Outstanding Balance Outstanding Balance Reason Reason Reason Unpaid Balance Unpaid Balance Unpaid Balance BUSINESS DEBT SUMMARY Total business debt list should match loans and leases on current business financial statement dated. Loan/Lease 1 Loan/Lease 2 Loan/Lease 3 Creditor Original Amount Original Date Present Balance Interest () Rate Maturity Date Monthly () Payment Collateral/Security Creditor Original Amount Original Date Present Balance Interest () Rate Maturity Date Monthly () Payment Collateral/Security Loan/Lease 4 Loan/Lease 5 Loan/Lease 6 FORM 03253 (Rev. 07/2009) eform 7 of 12
GENERAL INFORMATION--APPLICANT ONLY Answer all questions by checking YES or NO. Provide explanation(s) as applicable. 1. Are any assets pledged, or debts secured, except as shown? If YES, explain below. 2. If any assets above are owned by a trust, is a copy of the trust agreement available? 3. Have you obtained credit under other names or with other individuals? If YES, provide names and social security numbers. 4. Have you ever declared bankruptcy or had a judgement against you? If YES, explain below. 5. Have you ever been a principal or guarantor of a firm that declared bankruptcy? If YES, explain below. 6. Are you party to any claims or suits? If YES, explain below. 7. Have you been audited by the IRS in the past three years? 8. If YES, has the tax return been finalized with all issues settled? If NO, explain below. 9. Are you a director, executive officer or principal shareholder of any of the following: a. An insured bank or financial institution, which makes commercial loans and accepts deposits? b. The Bank of Tokyo-Mitsubishi Bank, Ltd.; UnionBanCal Corporation; or any of their subsidiaries? c. Any company controlled by any of the above? If YES, name of company: YES NO 10. Are you leasing any real or personal property? If YES, explain below. 11. Do you have any pending credit applications at any other financial institutions? If YES, explain below. 12. Have you ever been charged with, or convicted of, any criminal offense other than a misdemeanor involving a motor vehicle violation? a. Are you employed by the U.S. Government? If YES, give agency/position: b. Are you a U.S. Citizen? If NO, give Alien Registration number: c. Are you presently under indictment, on parole or probation? If YES, indicate date parole or probation is to expire: d. Have you ever been convicted, placed on pretrial diversion or placed on any form of probation, including adjudication withheld pending probation, for any criminal offense other than a minor vehicle violation? SIGNATURES Whether married, unmarried or separated, you may request individual credit by applying alone. Spouse's signature required only if you and your spouse are, or will be, jointly obligated on credit extended by Union Bank, N.A. SIGNATURE--Applicant DATE SIGNATURE--Spouse DATE EXPLANATION(S): FORM 03253 (Rev. 07/2009) eform 8 of 12
HISTORY OF BUSINESS BACKGROUND OF BUSINESS (i.e. date established, detail explanation of business operation, etc.). EXPLAIN IN DETAIL THE SPECIFIC PRODUCT OR SERVICE THIS BUSINESS OFFERS. WHAT HAS CAUSED THE NEED TO BORROW? (Explain the specific reasons which lead to the current financial needs of the business.) WHO ARE THE PRINCIPALS OF THIS BUSINESS? WHAT IS THEIR LEVEL OF EXPERIENCE? WILL THE FUNDING OF THIS LOAN CREATE NEW EMPLOYMENT OPPORTUNITIES? IF SO, STATE HOW. FORM 03253 (Rev. 07/2009) eform 9 of 12
CERTIFICATE OF SECRETARY NOTE: This applies to Corporations only I certify that I am the secretary of, and that the following persons hold positions in this corporation and/or own shares in this corporation in the amount and form designated. 1. DIRECTORS 2. OFFICERS President Vice President Secretary Treasurer 3. SHAREHOLDERS Name Number of Shares of Shares Outstanding Date: By: Secretary FORM 03253 (Rev. 07/2009) eform 10 of 12
BUSINESS OWNER MANAGEMENT RESUME (Additional forms available upon request.) Fill in all spaces, use full first, middle and maiden names, no initials. If an item is not applicable, indicate so. You may include additional relevant information on a separate exhibit. Sign and date where indicated. Name SSN - - First Middle Maiden Last Date of Birth Place of Birth Residence Telephone ( ) Business Telephone ( ) Residence Address Lived There From to Previous Address If less than 10 years at current residence Street City State Zip Month and Year Month and Year Street City State Zip Lived There From to Month and Year Month and Year Spouse's Name SSN - - First Middle Maiden Last EDUCATION High School/College/Technical--Name/Location Dates Attended Major Degree/Certificate MILITARY SERVICES BACKGROUND Branch From To WORK EXPERIENCE (List chronologically, beginning with present employment.) Present Company Name/Location From To Title Duties Company Name/Location From To Title Duties Company Name/Location From To Title Duties Signature Date FORM 03253 (Reg. 07/2009) eform 11 of 12
AUTHORIZATION TO RELEASE INFORMATION I/We hereby authorize the release of any and all information to Union Bank that they may require at any time for any purpose related to our credit transaction with them. I/We further authorize Union Bank to release such information to any entity they deem necessary for any purpose related to our credit transaction with them. A photographic or faxed copy of this authorization and my/our signature(s) may be deemed to be the equivalent of the original and may be used as a duplicate original. I/We hereby acknowledge that all loan approvals will be in writing and subject to the terms and conditions set forth in a commitment letter signed by an officer of Union Bank. Signature Date Signature Date Retain for your records the Equal Credit Notification Letter which accompanies this application. Please Initial TO COMPLETE LOAN PACKAGE, THE FOLLOWING INFORMATION MAY ALSO BE REQUIRED AS APPLICABLE: 1. Copy of "filed" Articles, By laws, Minutes, Stock Certificate(s), Fictitious Business Name filing. 2. Copy of business licenses and any permits required for your business. 3. Copy of current lease or rental agreement. 4. Aging report on Payable and Receivable Accounts by amount owed/due and age. (Must match financials.) 5. Proof of availability of down payment and closing expenses: statement(s) from sources of funds. 6. Provide name, fax and phone number of insurance carrier and agent for new building or life insurance. 7. Copy of Alien Registration card enlarged - both sides (OR) proof of citizenship if foreign born. 8. Copy of buy-sell agreement escrow instructions and preliminary title report. 9. Copy of leases for any remaining tenants in new property. (For appraiser and approval process.) 10. Copy of real estate flyer with picture and specifications on purchase of real estate. 11. Bids on purchase of inventory, equipment, fixtures and furniture. CONSTRUCTION IMPROVEMENTS FOR PROPERTY 1. Bid sheet from general contractor: () dollar amount, time frame from start to finish estimated. 2. Specification sheet: break down of expenses for appraiser--demo, drywall, electrical, flooring, etc. 3. Copy of plans including blueprints. OTHER ITEMS THAT WILL BE REQUIRED FOR CLOSING 1. Insurance binder for new property. 2. Copy of new lease between occupant of building and owner of building. 3. Other information as required by SBA and/or Union Bank. BY SIGNING BELOW YOU CERTIFY THAT ALL INFORMATION YOU'VE PROVIDED ON AND WITH THESE FORMS OR HEREAFTER FURNISHED BY YOU OR ON YOUR BEHALF, IS TRUE, CORRECT AND COMPLETE. You authorize us, from time to time, to make whatever inquiries we consider necessary and appropriate concerning information, including obtaining credit reports, credit references and employment verification. You agree to provide additional information that we may require to process this application including, but not limited to, true and complete federal income tax returns, employment verification and income verification. You authorize us to obtain address, information at any time from the California Department of Motor Vehicles and waive the address confidentially requirement section 1808.21 of the California Vehicle code. The Bank will review this application in California and the contract is made in California. X Applicant's Signature Print Name Title FORM 03253 (Rev. 07/2009) eform 12 of 12