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Form #1398Small business, Loan Application Checklist
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Small business, Loan Application Checklist
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Small business. Â
Loan
Application Checklist
IN ORDER TO PROVIDE PROMPTER RESPONSE TIME TO SBA LOAN
APPLICATIONS, PLEASE COMPLETE AND SUBMIT THIS CHECKLIST WITH THE APPLICATION TO
YOUR BANK. WITH FEW EXCEPTIONS, THIS CHECKLIST, WHEN COMPLETED, SHOULD
CONSTITUTE AN ACCEPTABLE APPLICATION. PLEASE NOTE THAT ALL DOCUMENTS MUST BE
SIGNED AND DATED.
CREDIT DOCUMENTATION REQUIREMENTS:
—. SBA Form 4, "Application for Business
Loan." Fully completed. SIGNED AND DATED by a principal or partner as
required. If prepared by someone other than applicant, fees disclosed on SBA
Form 4.
—. SBA Form 413, Personal Financial Statement.
Submitted (SIGNED AND DATED) by each stockholder with 20% or greater ownership,
each officer regardless of ownership percentage, each partner, or the
individual proprietor.
—. SIGNED AND DATED fiscal year-end balance sheets and
income statements (or business tax statements) for each of the last three
years. These same statements are also required from affiliated companies.
—. SIGNED AND DATED balance sheet and income statement
current within 90 days as of the date the application will be submitted to SBA.
The Indebtedness Section of SBA Form 4, Application for Business Loan, should
agree with the indebtedness reflected on this financial statement. These
same financial statements are required from affiliated companies.
—. A SIGNED AND DATED aging of Accounts Receivable and
Payable as of the current balance sheet.
—. Reconciliation of net worth covering all financial
statements submitted.
—. SIGNED AND DATED Form MWR-1, signed and dated two
years earnings projection. This may be on another form as long as the
information is provided. Must be accompanied by a detailed narrative as to how
the projected income and expense figures were derived.
—. SIGNED AND DATED Monthly Cash Flow projection for
first 12 months after loan. This is mandatory in all line of
credit applications.
—. SIGNED AND DATED history of the business, including
the benefits expected from the loan.
—. SIGNED AND DATED resume(s) of the Management
(regardless of amount of ownership) of the business.
—. SIGNED AND DATED list of any equipment being
purchased and vendor's quotes or estimated cost per item.
—. For construction, contractor's estimates and
preliminary construction plans and specifications.
—. SBA Form 641, Request for Counseling.
—. Provide copies of all of the following, as
appropriate: 1) Lease. 2) Franchise Agreement, complete with FTC Disclosure
statement. 3) Purchase agreements (change of business ownership or real estate).
4) Copy of appraisal(s). 5) Copy of any note(s) being paid from loan proceeds.
—. If a new business start or change of business
ownership, provide a SIGNED AND DATED capital investment balance sheet and the
source and use of the applicant's investment.
—. SBA Form 159, Compensation Agreement for Services
in Connection with Application when fees have been charged for Preparation of
the Application.
—. Where non-residential real estate is being pledged
as collateral, an ENVIRONMENTAL QUESTIONNAIRE MUST be submitted with the
application, completed, signed, and dated by the LENDER and
signed and dated by a principal of the small business concern.
—. SBA Form 4-I, Lender's Application for Guaranty or
Participation. FULLY COMPLETED front and reverse sides, including
proforma balance sheet and historical, interim and projected P&L spreads;
complete financial analysis covering the five (5) subjects identified in the
instructions. SIGNATURE AND TITLE OF OFFICER ACTING ON BEHALF OF THE LENDER.
REGULATORY REQUIREMENTS: The following documents must be submitted; our office
cannot accept applications without the following documents:
—. SBA Form 912, Statement of Personal History. Must
be provided by the same individuals as personal financial statement above.
Also, for all directors if business is a corporation or day-to-day managers.
—. SBA Form 1624, Certification Regarding Debarment,
Suspension, Ineligibility and Voluntary Exclusion—Lower Tier Covered
Transactions. Completed, SIGNED AND DATED by Authorized Representative of the
Company. (Guaranteed bank loans only—TO BE RETAINED BY BANK).
—. SBA Form 1846, Statement for Loan Guarantees and
Loan Insurance, to be SIGNED AND DATED by the Lender.
_________SIGNATURE OF LENDER VERIFYING
DOCUMENTATION
DIRECT LOANS ONLY:
—. Two Bank Decline Letters. One MUST be from your
bank of account. Letters must include name and telephone number of banker,
amount and terms of the loan requested, reason(s) for decline, and whether or
not the bank will participate with SBA. In cities with 200,000 people or less,
one decline letter from applicant's bank of account will be sufficient.
—. If Vietnam Veteran, a copy of DD-214 showing length
of service and honorable discharge. If disabled Vet, letter from Veterans
Affairs physician or official documenting degree of disability.
—. If handicapped, letter from physician or therapist
certifying handicap, its permanence, and the limitations place upon the
applicant due to handicap.
—. SBA Form 1623, Certification Regarding Debarment,
Suspension, and Other Responsibility Matters—Primary Covered Transactions.
Completed, SIGNED AND DATED by authorized representative of the company. THIS
IS A REGULATORY REQUIREMENT.
ESTIMATED PROJECTION AND
FORECAST OF TWO YEARS EARNINGS ATTACH A NARRATIVE EXPLAINING THE BASIS FOR THE
SALES AND EXPENSE FIGURES
|
Â
|
YEAR
|
% of Sales
|
Â
|
% of Sales
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|
Gross Receipts
|
$........................
|
_____%
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$........................
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_____%
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|
Opening Inventory ................................................................... Â
|
.......................... Â
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.......................... Â
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.......................... Â
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.......................... Â
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Materials
|
.......................... Â
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.......................... Â
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.......................... Â
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.......................... Â
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|
Direct Labor .............................................................................. Â
|
.......................... Â
|
.......................... Â
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.......................... Â
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.......................... Â
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Subcontract Cost ...................................................................... Â
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.......................... Â
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.......................... Â
|
.......................... Â
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.......................... Â
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|
Purchases .................................................................................. Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
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.......................... Â
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|
Overheads ................................................................................. Â
|
.......................... Â
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.......................... Â
|
.......................... Â
|
.......................... Â
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|
Totals ......................................................................................... Â
|
.......................... Â
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.......................... Â
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.......................... Â
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.......................... Â
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|
Less Ending Inventory ............................................................. Â
|
.......................... Â
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.......................... Â
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.......................... Â
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.......................... Â
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|
Cost of Goods Sold .................................................................. Â
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.......................... Â
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.......................... Â
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.......................... Â
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.......................... Â
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Gross Profit ............................................................................... Â
|
$........................
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_____%
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$........................
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_____%
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|
Expenses
|
|
|
|
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|
Officer's Salaries ..................................................................... Â
|
.......................... Â
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.......................... Â
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.......................... Â
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.......................... Â
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(if corporation)
|
|
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Employee wages ....................................................................... Â
|
.......................... Â
|
.......................... Â
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.......................... Â
|
.......................... Â
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Accounting & Legal fees .......................................................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
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|
Advertising ................................................................................ Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
|
Rent ............................................................................................. Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
|
Depreciation ............................................................................. Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
|
Supplies ..................................................................................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
|
Electricity .................................................................................. Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
|
Telephone .................................................................................. Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
|
Interest ....................................................................................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
|
Repairs ....................................................................................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
|
Taxes .......................................................................................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
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|
Insurance .................................................................................. Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
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|
Bad Debts .................................................................................. Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
|
 Miscellaneous ......................................................................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
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(postage, etc.)
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|
|
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Total Expenses .......................................................................... Â
|
$........................
|
_____%
|
$........................
|
_____%
|
|
Net Profit ................................................................................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
|
Less: Federal Income Tax ........................................................ Â
|
.......................... Â
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.......................... Â
|
.......................... Â
|
.......................... Â
|
|
Less: State Income Tax ............................................................ Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
|
Net Profit After Taxes .............................................................. Â
|
.......................... Â
|
.......................... Â
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.......................... Â
|
.......................... Â
|
|
Less: Withdrawals ................................................................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
.......................... Â
|
|
(proprietorship/partnership)
|
|
|
|
|
|
Net Profit remaining for loan Payments ............................. Â
|
$........................
|
_____%
|
$........................
|
_____%
|
Overhead to be broken down into major
expense categories such as supplies, occasional labor, etc. on separate
schedules.
_________NAME _________TITLE _________DATE
|
MWR Form 1 (5/89)
|
IMPORTANT: This sheet
must be signed and dated.
|
A. Reflects the full name of the Company/Business
owned. Leave blank if you are not yet in business.
B. Name. If partnership or corporation, enter only one
name.
C. through H. Complete as indicated.
I. Reflects the client's PRIMARY business.
J. Complete as indicated. (Check only one)
If in business, this box refers to owner of business.
If going into business this box refers to the applicant's gender. If joint
ownership, No. 3 refers to male and female joint ownership.
K. Complete as indicated. (Check all that apply)
L. Complete as indicated. (Requires multiple answers)
M. Requires two answers.
Select one answer for RACE and one answer for
ETHNICITY.
N. Complete as indicated. (Narrative answer required)
O. Complete as indicated. (Requires multiple answers)
P. Complete as indicated.
Q. To be completed by counselor. (Check all that
apply)
Q2. Applicant—refers to applicants for SBA financial
assistance.
Q4. COC—refers to applicants who have applied for
Certificate of Competence
R. Determine the area for which you will provide
assistance. (Check only one)
Environmental
Questionnaire
Instructions: The following shall be used as a guide
to determine if Phase I or Phase II audit is needed, and is to be completed
during an on-site inspection by the lender where commercial real estate is to
be taken as collateral (residential real estate is excluded).
1. Determine the prior, current, and planned uses for
the property. If any of these uses involves an operation that used or uses
toxic chemicals, conduct a Phase I audit. (Discussions with current/prospective
owners can help identify uses.)
2. To the extent possible, determine the prior,
current, and planned uses of all adjoining property. If any of these uses
involves an operation that used or uses toxic chemicals, conduct a Phase I
audit. (Discussions with current/prospective owners, as well as a visual check,
can help identify uses.)
3. Conduct a visual inspection of the facility,
preferably accompanied by current owners. The following observations may
trigger the need for a Phase I audit:
any evidence that chemicals are used in the operation
of the facility.
discarded chemical containers.
waste piles of any type (ask about buried waste and
the presence of underground storage tanks).
evidence of distressed vegetation or nonvegetation
areas.
oily films on standing water.
discolored soils.
unusual odors.
4. Determine that the applicant has all relevant
environmental permits and/or notifications in place. If not, conduct a Phase I
audit. (Local regulatory authorities could be consulted for assistance on
requirements.)
5. Determine whether the facility has ever been
involved in:
any citations, claims, or complaints regarding environmental
problems.
any notices of violations.
any environmental clean-up actions.
(Discussions with the applicant, as well as local
regulatory authorities, can identify facility abuse.) If yes on any point,
conduct a Phase I audit.
SBA Form 1738
Lender Recommendation
and Report
Lender or SBA Report on Issues Covered by This
Questionnaire (Attach additional sheets if necessary):
Recommendation:
_______________
Name of Lender
By: _________
Title:
Date: _________
Acknowledgement By The Applicant:
I acknowledge that I have read this questionnaire, and
have responded to the issues and questions posed therein to the best of my
knowledge.
_______________
Business Name
By: _________
Title:
Date: _________
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These forms are provided to assist business owners and others in understanding important
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acceptable in one state may not be enforced the same way under the laws of another
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