SBA Loan Checklist Ownership Information Completed Credit Application Completed Personal Financial Statement (for each owner) 3 Years Personal Federal Tax Returns (for each owner) Management Profile (form attached) Personal Cash Flow Statement (form attached) SBA Form 4506 Verification of Personal Tax Returns SBA Form 912 Statement of Personal History Site Information MAI Appraisal and/or Feasibility Study (if available) Copy of preliminary site plan (if available) Copy of property leases (if applicable) Copy of purchase and sales agreement / option (if applicable) Copy of environmental documentation (if available) Business Information Business Profile (form attached) Copy of corporate documents (articles of incorporation, partnership agreement, LLC articles of organization ) Business Plan with Projections. 3 Years Business Federal Tax Returns & Financials (balance sheet, profit & loss) Current interim business financials (balance sheet, profit & loss) Business Debt Schedule (form attached) SBA Form 4506 Verification of Business Tax Returns (if applicable) Coast Commercial Credit LLC 63 Fletcher Court, Bay Point, CA 94565 Telephone: 925-709-5015 Fax: 925-709-5017 Toll Free: 800-400-0365
Coast Commercial Credit SBA Loan Application Business Name Date Established Tax I.D. Current Address Tel Fax City, State, Zip Type of Business Business Structure Number of Employees: Before Loan After Loan Corporation Partnership Proposed New Address LLC Sole Prop Current Bank and Address Estimated Use of Proposed Loan Proceeds Land Acquisition $ New Building Construction $ Land and Building Acquisition $ Building Improvements or Repairs $ Leasehold Improvements $ Machinery & Equipment $ Furniture & Fixtures $ Inventory Purchase $ Acquisition of Existing Business $ Refinance Existing Bank Loan $ Other Debt Repayment $ Working Capital $ TOTAL CAPITAL REQUIREMENTS $ Cash Being Provided by Borrower $ Funds Provided by Other Sources $ LOAN AMOUNT REQUESTED $ side Continued on back
SBA Loan Application continued List any previous SBA or other Federal Government Debt NAME OF AGENCY ORIGINAL AMOUNT OF LOAN DATE OF REQUEST APPROVED OR DECLINED BALANCE CURRENT OR PAST DUE ASSISTANCE List the name and occupation of anyone who assisted in the preparation of this form. Name Fees Paid $ Occupation MANAGEMENT (proprietor, partners, officers, directors, and all holders of outstanding stock 100% ownership must be shown) NAME TITLE % OWNERSHIP AFFILIATES (List below any business concern in which the applicant company or any of the individuals listed above have any ownership.) NAME TITLE % OWNERSHIP YES* Have you or any officer of your company ever been involved in bankruptcy or insolvency proceedings? * Are you or your business involved in any pending lawsuits? * Does any applicant or their spouse or any member of their household, or any one who owns, manages or directs your business or their spouses or members of their household work for the Small Business * Administration, Small Business Advisory Council, SCORE or ACE, and Federal Agency, or the participating lender? Does your business presently, or as a result of this loan, engage in export trade? * Does the company or any owner own title to a patented, trademarked, or copyrighted product? * Does the company maintain Life Insurance on any owner or officer? * Insure d Insure d Beneficiary Amount $ Beneficiary Amount $ *If YES, please provide the details. AUTHORIZATION FOR DISCLOSURE OF CREDIT INFORMATION Because I have applied to Coast Commercial Credit, LLC for financing, I hereby authorize you to disclose to Coast Commercial Credit or its assignees the personal and/or business information as may be required concerning the above statements or attached enclosures within the framework of the Fair Credit Reporting Act. I hereby represent to Coast Commercial Credit or its assignees that such information is true, correct and complete. A Photostatted copy of this authorization shall be valid as the original. The applicant agrees that Coast Commercial Credit or its assignees have the right to confirm the accuracy of the above credit information and that Coast Commercial Credit or its assignees have the right to accept or reject this credit application. The applicant understands that Coast Commercial Credit or its assignees are relying on the credit application and financial statements submitted by the applicant in making its decision in whether to approve the credit request. The applicant agrees to inform Coast Commercial Credit or its assignees immediately of any matter that will cause any significant change in the applicant s financial condition. The applicant agrees to irrevocably release Coast Commercial Credit or its assignees from any and all liability associated with this transaction. The applicant irrevocably authorizes Commercial Credit or its assignees to execute and file UCC financing statements and/or execute credit request authorizations in any and all names related to this transaction. NO SIGNATURE TITLE DATE SIGNATURE TITLE DATE SIGNATURE TITLE DATE SIGNATURE TITLE DATE
Business Profile (If not attached) Please give a brief history, included the year founded, by whom, products or services provided, and where the business is located. Who are your major customers? Name Location Percent (%) of Sales Who are your major suppliers? Name Location Product Purchased Who are your major competitors? Name Location Competing Product How will the SBA Loan change or aid the growth of the business? By signing below you certify that the information you ve given with this Application is true and complete. You authorize us to verify your statements with any source and obtain credit and employment history (including your spouse s if you live in a community property state). DATE YOUR SIGNATURE
Management Profile Who Needs to Complete? Proprietor, each partner, holder of 20% or more of common stock, and/or key management. Name Birth Date Place U.S. Citizen? Yes No If No, give Alien Registration No. and copy of Green Card. Home Telephone Social Security Number Present Residence From To Address City, State, County, Zip Immediate Past Residence From To Address City, State, County, Zip Please answer the next three questions. (*If YES<, please provide the details.) YES* NO Are you presently under indictment, on parole or on probation? Have you ever been charged with or arrested for any criminal offense other than a minor motor vehicle violation? Have you ever been convicted of any criminal offense other than a minor motor vehicle violation? Education History (if not attached) Institution Dates Degree Employment Experience for prior Ten Years (if not attached) Employer/Location From To Position Responsibilities Employer/Location From To Position Responsibilities Ethnic Background African American Native American Eskimo/Aleutian Asian/Pacific Islander White Other Ethnic Background Yes No Puerto Rican Military Status From To Branch Veteran Vietnam Era Vet Non-Vet Disabled Vet Discharge: Rank Honorable? Yes/No This data is collected for statistical purposes only. It has no bearing on the credit decision to approve or decline the application. DATE YOUR SIGNATURE Information above is the same date required for SBA Form 912, Statement of Personal History.
Business Debt Schedule Company Name Date Signature INDEBTEDNESS: Furnish the following information on all installments debts, contracts, notes, and mortgages payable. Indicate by asterisk (*) items to be paid by loan proceeds and reason for paying same (present balance should agree with latest balance sheet submitted). Do not include accounts payable or accrued liabilities. CREDITOR Name and Address Original Date Original Amount Present Balance Interest Rate Monthly Payment Maturity Date Collateral/Security Total Present Balance
Projected Profit/Loss Applicant Name Date Period Covering Total Net Sales Cost of Goods Sold Gross Profit Controllable Expenses Salaries/Wages Payroll Taxes Legal/Accounting Advertising Automobile Office Supplies Dues/Subscriptions Telephone Utilities Miscellaneous Total Controllable Expense Fixed Expenses Rent Licenses/Permits Taxes Interest Other Expenses Total Fixed Expenses Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Month 7 Month 8 Month 9 Month 10 Month 11 Month 12 Total Percent Total Expenses Profit / (Loss) before Tax Income Tax Net Profit
(PHOTOCOPY FOR EACH APPLICANT) Personal Financial Statement U.S. SMALL BUSINESS ADMINISTRATION As of, 20 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, or (4) any person or entity providing a guaranty on the loan. Name Business Phone Residence Address Residence Phone City, State, & Zip Code Business Name or Applicant/Borrower ASSETS (Omit Cents) LIABILITIES (Omit Cents) Cash on hands & in Banks $ Accounts Payable $ Savings Accounts $ Notes Payable to Banks and Others (Describe in Section 2) IRA or Other Retirement Account $ Installment Account (Auto) Monthly Payments $ Accounts & Notes Receivable $ Installment Account (Other) Life Insurance-Cash Surrender Value Only (Complete Section 8) Monthly Payments $ $ Loan on Life Insurance $ Stocks and Bonds (Describe in Section 3) $ Mortgages on Real Estate (Describe in Section 4) $ Real Estate (Describe in Section 4) $ Unpaid Taxes (Describe in Section 6) $ Automobile-Present Value $ Other Liabilities (Describe in Section 7) $ Other Personal Property (Describe in Section 5) $ Total Liabilities $ Other Assets (Describe in Section 5) $ Net Worth $ Total $ Total $ Section 1. Source of Income Contingent Liabilities Salary $ As Endorser or Co-Maker $ Net Investment Income $ Legal Claims & Judgments $ Real Estate Income $ Provision for Federal Income Tax $ Other Income (Describe below)* $ Other Special Debt $ Description of Other Income in Section 1 $ $ $ *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. (Use attachments if necessary. Each attachment must be identified as a part of this statement and signed.) Name and Address of Noteholder(s) Original Balance Current Balance Payment Amount Frequency (monthly, etc.) How Secured or Endorsed Type of Collateral SBA Form 413 (2-94) Use 5-91 Edition until stock is exhausted. Ref: SOP 50-10 and 50-30
(PHOTOCOPY FOR EACH APPLICANT) Section 3. Number of Shares Name of Securities Cost Market Value Quotation/Exchang e Date of Quotation/Exchange Total Value Section 4. Type of Property Address 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. (List each parcel separately. Use attachment if necessary. Each attachment must be identified as a part of this statement and signed.) Property A Property B Property C (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 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: PLEASE NOTE: 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 Officer, Paper Reduction Project (3245-0188), Office of Management and Budget, Washington, D.C. 20503.
Personal Cash Flow Statement Please provide the following information regarding sources and uses of cash during the calndar year and your projections for the current year. If a cash flow deficit exists, explain how the existing or requested debt will be serviced. Individual Statement Joint Statement Sources of Cash (Annual) Prior Year 2000 Current Year Estimate 1. Salaries, Commissions, Bonuses, or any other $ $ income from employement (net) 2. Rents received $ $ 3. Dividends $ $ 4. Interest Income $ $ 5. Sale of Assets $ $ 6. Royalties $ $ 7. Distributions from Estates & Taxes $ $ 8. Cash distributions from businesspartnerships, or joint $ $ ventures 9. Income tax refund $ $ 10. Other sources of cash $ $ TOTAL CASH RECEIVED $ $ Use of Cash (Annual) Prior Year 2000 Current Year Estimate 1. Personal Expenses (Utilities, rent, household, etc.) $ $ 2. Bank loans principal & interest $ $ 3. Other loans principal & interest $ $ 4. Insurance Payments $ $ 5. Income taxes not covered by withholding $ $ 6. Other uses of cash $ $ TOTAL CASH OUTLAYS $ $ CASH FLOW SURPLUS (DEFICIT) $ $ This Cash Flow Statement is a part of my financial statement: APPLICANT S SIGNATURE DATE CO-APPLICANT S (SPOUSE) SIGNATURE