S
OMB Approval No.: 3245-0348
Effective Date:
Expiration Date:
MB Approval No.: 3245-0348
Effective Date: 02/19/2004
Expiration Date: 02/28/2007
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(Revolving - Yes |
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No |
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(SBA Export Express - Yes |
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No |
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(Revolving - Yes |
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No |
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Borrower Name: |
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Trade Name (dba): |
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(if no trade name, enter “NA”) |
Borrower Contact: |
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First |
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MI |
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Last |
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Borrower Street: |
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Borrower Zip Code: |
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Borrower Phone #: |
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Borrower SSN #: |
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(must include SSN # for principal of borrower) |
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Employer ID #: |
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(if available) |
Borrower State: |
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(2 letter abbreviation) |
Borrower County: |
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Borrower City: |
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Lender Name: |
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Lender ID #: |
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Loan Maturity: |
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(in months) |
Loan Amount: |
$ |
SBA Guaranty %: |
% |
Construction Amount: |
$ |
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Variable Interest Rate: P+ |
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Initial Bank Interest Rate: |
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Exporter? |
Yes |
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No |
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If yes, amount in export sales applicant has projected loan will support
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$ |
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Rural |
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Urban |
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NAICS Code: |
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Number of Employees: |
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Number of Jobs Created: |
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Number of Jobs Retained: |
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Franchiser’s Name: |
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SBA USE ONLY: |
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Veteran Status: ** |
Non-Veteran; Other Vet.; Service-Disabled Vet.; Not Disclosed. |
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Gender: ** |
Male; Female; Not Disclosed |
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Race:**
Ethnicity:** |
American Indian/Alaska Native; Asian; Black/African-American; Native Hawaiian/Pacific Islander; White/Caucasian; Not Disclosed Hispanic/Latino; Not Hispanic/Latino; Not Disclosed |
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Owner # |
% Owned |
Veteran Code |
Gender Code |
Race |
Ethnicity |
Please reference the above codes to complete this table for each 20% or greater owner of the primary business associated with the borrower. More than one race code may be selected. |
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SBA |
Loan |
SBA |
Term |
Were any other SBA loans with maturities of more than 12 months made to the borrower in the last 90 days? If so, please complete for each loan |
SBA Loan # |
Approval Date |
Amount |
Guaranty % |
(in months) |
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SBA Form 1920SX (Part B) Page 1 of 2
Supplemental Information for PLP/SBAExpress Processing
Borrower Name: |
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Use of Loan Proceeds |
Amount |
Purchase Land |
$ |
Purchase Land and Improvements |
$ |
Purchase Improvements |
$ |
Construct a Building |
$ |
Add an Addition to a Building |
$ |
Make Renovations to a Building |
$ |
Pay Off Interim Construction Loan |
$ |
Pay Off Lender’s Interim Loan |
$ |
Make Leasehold Improvements to a Building |
$ |
Purchase Equipment |
$ |
Purchase Fixtures |
$ |
Purchase Inventory |
$ |
Pay Trade or Accounts Payable |
$ |
Pay Notes Payable |
$ |
Pay Outstanding Debt |
$ |
Purchase a Business |
$ |
Purchase All Outstanding Stock |
$ |
Pay SBA Loan |
$ |
Working Capital |
$ |
Pay the Guaranty Fee |
$ |
Other |
$ |
Total |
$ |
** The gender/race/ethnicity/veteran data is collected for statistical purposes only; disclosure is voluntary and has no bearing on the credit decision.
Lender Contact: |
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First |
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MI |
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Last |
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Lender Contact Phone #: |
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Lender Contact Fax #: |
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The estimated burden for completing this form is 10 minutes. You will not be required to respond to any collection of information unless it displays a currently valid OMB Control Number. Comments on the burden should be sent to U. S. Small Business Administration (SBA), Chief, AIB, 409 3rd Street, SW, Washington, DC 20416 and Desk Officer for SBA, Office of Management and Budget, New Executive Office Building, Rom 10202, Washington, DC 20503. OMB Control Number 3245-0348. PLEASE DO NOT SEND FORMS TO OMB.
SBA Form 1920SX (Part B) Page 2 of 2
File Type | application/msword |
File Title | 4-I Supplemental Information for PLP Processing |
Author | Karen Diarra |
Last Modified By | CBRich |
File Modified | 2007-04-30 |
File Created | 2007-04-30 |