Get Sba Form 5 2018-2025

INSURANCE COVERAGE IF ANY Inventory Leasehold Improvements Coverage Type Name of Insurance Company and Agent Phone Number of Insurance Agent SBA Form 5 02-15 Ref SOP 50 30 Policy Number 17. 19. Regarding you or any joint applicant listed in Item 17 a are you presently subject to an indictment criminal information arraignment or other means by which formal criminal charges are brought in any jurisdiction b have you been arrested in the past six months for any criminal offense c for any criminal offense - other than a minor vehicle violation - have you ever 1 been convicted 2 plead guilty 3 plead nolo contendere 4 been placed on pretrial diversion or 5 been placed on any form of parole or probation including probation before judgement If yes Name PHYSICAL DAMAGE LOANS ONLY. If your application is approved you may be eligible for additional funds to cover the cost of mitigating measures real property improvements or devices to minimize or protect against future damage from the same type of disaster event. It is not necessary for you to submit the description and cost estimates with the application. SBA must approve the mitigating measures By checking this box I am interested in having SBA consider this increase. Student etc. Federal contracts Federal grants or any child support payments. f. Does any owner owner s spouse or household member work for SBA or serve as a member of SBA s SCORE ACE or Advisory Council. g. Is the applicant or any listed owner currently suspended or debarred from contracting with the Federal government or receiving Federal grants or loans. 19. Regarding you or any joint applicant listed in Item 17 a are you presently subject to an indictment criminal information arraignment or other means by which formal criminal charges are brought in any jurisdiction b have you been arrested in the past six months for any criminal offense c for any criminal offense - other than a minor vehicle violation - have you ever 1 been convicted 2 plead guilty 3 plead nolo contendere 4 been placed on pretrial diversion or 5 been placed on any form of parole or probation including probation before judgement If yes Name PHYSICAL DAMAGE LOANS ONLY. This application SBA Form 5 completed and signed Tax Information Authorization IRS Form 8821/4506-T completed and signed by each applicant each principal owning 20 percent or more of the applicant business each general partner or managing member and for any owner who has a subsidiaries and/or other businesses with common ownership or management Complete copies including all schedules of the most recent Federal income tax returns for the applicant business an explanation if not available Personal Financial Statement SBA Form 413 completed signed and dated by the applicant if a sole proprietorship each principal owning 20 percent or more of the applicant business and each general partner or managing member Schedule of Liabilities listing all fixed debts SBA Form 2202 may be used ADDITIONAL REQUIREMENTS FOR MILITARY RESERVIST ECONOMIC INJURY MREIDL A copy of the essential employee s notice of expected call-up to active duty or official call-up orders or release/discharge from active duty A written explanation and financial estimate of how the call-up of the essential employee has or will result in economic injury to your business and the steps your business is taking to alleviate the economic injury ADDITIONAL INFORMATION MAY BE NECESSARY TO PROCESS YOUR APPLICATION. IF REQUESTED PLEASE PROVIDE WITHIN 7 DAYS OF THE INFORMATION REQUEST Complete copy including all schedules of the most recent Federal income tax return for each principal owning If the most recent Federal income tax return has not been filed a year-end profit-and-loss statement and balance sheet for that tax year A current year-to-date profit-and-loss statement Additional Filing Requirements SBA Form 1368 providing monthly sales figures NOTE PLEASE READ DETACH AND KEEP FOR YOUR RECORDS STATEMENTS REQUIRED BY LAWS AND EXECUTIVE ORDERS To comply with legislation passed by the Congress and Executive Orders issued by the President Federal executive agencies including the Small Business Administration SBA must notify you of certain information. You can find the regulations and policies implementing these laws and Executive Orders in Title 13 Code of Federal Regulations CFR Chapter 1 or our Standard Operating Procedures SOPs. The request must describe the specific records you want. For information about the FOIA contact the Chief FOI/PA Office 409 3rd Street SW Suite 5900 Washington DC 20416 or by e-mail at foia sba.gov. PRIVACY ACT 5 U.S.C. In order to provide the required notices the following is a brief summary of the various laws and Executive Orders that affect SBA s Disaster Loan Programs. FREEDOM OF INFORMATION ACT 5 U.S.C. 552 This law provides with some exceptions that we must make records or portions of records contained in our files available to persons requesting them. This generally includes aggregate statistical information on our disaster loan programs and other information such as names of borrowers and their officers directors stockholders or partners loan amounts at maturity the collateral pledged and the general purpose of loans. FREEDOM OF INFORMATION ACT 5 U.S.C. 552 This law provides with some exceptions that we must make records or portions of records contained in our files available to persons requesting them. This generally includes aggregate statistical information on our disaster loan programs and other information such as names of borrowers and their officers directors stockholders or partners loan amounts at maturity the collateral pledged and the general purpose of loans. We do not routinely make available to third parties your proprietary data without first doing pre-notification required by Executive Order 12600 or information that would cause competitive harm or constitute a clearly unwarranted invasion of personal privacy. Send a request under this Act to the SBA office maintaining the records requested and identify it as a Freedom of Information Act FOIA request.