Form 1450 8(a) Annual Update

OMB APPROVAL NO. 3245-0205
Expiration Date: 01/31/2009

8(a) ANNUAL UPDATE
Under 15 USC 636(j)10) each Program Participant is required to submit a business plan to SBA as condition of participation
and to review that plan with the Agency annually. SBA is collecting this information to ensure continuing eligibility for
participation in the 8(a) Business Development Program to the requirements listed in 13 CFR 124.112.
All information collected will be protected to the extent permitted by law, including the Freedom of Information Act, (5
U.S.C. 552), Privacy Act (5 U.S.C. 555a) and the Right to Financial Privacy Act of 1978 (12 U.S.C. 3401).

1.

Business Information:
Month / Day/Year

The following fields have been filled with information from SBA records, please review and correct the pre-filled data and enter missing data as appropriate.

Case No.:

SBA Customer
Number:

8(a) Approval Date:

CCR/DSBS Last Updated:
Transition Stage Date:

8(a) End Date:

Company Name:
Address:
City:
E-mail Address:

2.

State:

ZIP:

Phone No.:

FAX No:

Personal Financial Information: A Personal Financial Statement, SBA Form 413, must be completed and submitted for
each disadvantaged owner upon whom 8(a) certification was based. Each individual reporting must also include their most
recent tax return, including all schedules, attachments and supporting 1099 forms. [13 CFR 124.112 (b) (3)]

3.

Annual Compensation Data: A record of all payments, compensation, and distributions (including loans, advances salaries
and dividends) made by the participant to each of its owners, officers or directors, or to any person or entity affiliated with such
individuals. Use Individual Compensation Worksheet, Attachment A. [124.112 (b) (5)]

4.

Transferred Assets: A record from each individual claiming disadvantaged status regarding the transfer of assets for less than
fair market value to any immediate family member or to a trust any beneficiary of which is an immediate family member, within
No
two years of the date of this annual review. [124.112 (b) (4)] Have any assets been transferred since last review. Yes
If yes, please explain on a separate sheet of paper.

5.

Business Tax Return: A copy of the participant firm’s most recent year-end business tax return including all schedules and
attachments and a completed copy of IRS Form 4506, request for copy or transcript of Tax Form must be included with this 8(a)
annual update. [124.112 (b) (7)]

6.

Business Structure/Ownership Changes: Have there been any changes in the Partnership Agreement, Articles of
Incorporation, By-Laws or stock issues since your firm was certified for 8(a) participation that have not been previously reported
No
If yes, please submit information about those changes with this annual update. [124.112 (a)]
to SBA? Yes

7.

Adverse Actions: Are there any pending adverse actions (such as lawsuits, delinquent taxes, bankruptcy filings, creditor
problems, contract disputes, etc.) which may affect your business operation? Yes
sheet of paper. [124.112 (b) (2)]

8.
9.

No

If yes, please explain on a separate

Business Financials: Copy of latest firm’s Balance Sheet and Income Statements.
Access to credit and Capital: List all loans, lines of credit or other sources of capital available to the participant firm.
[124.302 (b) (3)]

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9. Continued:

Loan(s): Provide the following information for each loan.
Source:

Date of Loan:
Month / Day /Year

Purpose of Loan:
Original Amount: $

Balance: $

Status of Loan:

Secured by:
Terms:

Line(s) of Credit: Provide the following information for each line of credit.
Source:

Date of Loan:
Month / Day /Year

Purpose of Loan:
Original Amount: $

Balance: $

Status of Loan:

Secured by:
Terms:

10.

Other Sources of Capital: Please list all other sources of capital available to participant firm.
Source:

Date of Loan:
Month / Day /Year

Purpose of Loan:
Original Amount: $

Balance: $

Status of Loan:

Secured by:
Terms:

11.

Bonding Information: If a construction firm, what is current bonding limit? [124.302 (b) (4)]
Single job: $

Aggregate: $

Individual Surety:
Is SBA guaranty required?

12.

Corporate Treasury Listed Surety:
————————

Yes

No

Sometimes

Business Activity Report: On a separate sheet of paper provide a report of all non-8(a) contracts, options and modifications
affecting price executed during the program year. Indicate below, total of all non-8(a) revenue and 8(a) revenue earned during
the program year. [124.509 (c) (ii)]
This report will be made for the program year starting on
Month/ Day/ Year

Non-8(a) sales:
8(a) sales
Total sales
for program year:

.

and ending

$
$
$
$

(
(
(
(

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Month/ Day/ Year

%)
%)
%)
100 %)

How many competitive solicitations (private, federal, state or local) have you responded to within the last program year?
Commercial:

Local government:

State government:

Federal Non-8(a):

Federal 8(a):

Total:

Please explain on a separate sheet of paper the efforts made by your firm to pursue non-8(a) sales during the last program year.

13.

Number of Employees: Please indicate how many employees you have.
Full time

Part time

as of
Month/Day/Year

14. Mentor/Protégé: For the program year being reviewed were you a participant in an SBA approved or any approved
mentor/protégé agreement? [124.520]
Worksheet:

Yes

No If yes please complete Attachment “B” Mentor/Protégé

15. Joint Venture: Are you a participant in a joint venture (JV) agreement(s)?
Yes

No

For each joint venture indicate:
JV Name

JV Partner

16.

Award date

Prime Contract #

by jurisdiction:

Taxes: Indicate taxes your firm paid for fiscal year ending
Federal:
State:
Local:

17.

[124.513]

$
$
$

Contract Forecast: Each participant must annually forecast its needs for contract awards for the next program year. The
forecast must include the aggregate dollar value of 8(a) contracts broken down by sole source and competitive opportunities
where possible; the aggregate dollar value of non-8(a) contract; the types of contract opportunities identified by product or
service. [124.403 (b)]
8(a) Forecast
Sole Source
Competitive
Total

Non-8(a) Forecast

$
$
$

$
$
$

Total Forecast (includes both 8(a) and Non-8(a)): $

Briefly identify the types of contract opportunities sought.

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Transition Management Plan
Beginning in the first year of the transitional stage of program participation (years 5 through 9) each participant must annually submit a
transition management strategy to be incorporated into its business plan. This transition management strategy must describe: 124.403 ©

How you plan to meet the applicable non-8(a) business activity targets, imposed by 124.509 during the transitional stage.
[124.403 (c) (1)]

Indicate the specific steps you intend to take to continue business growth and promote profitable business operations
after the expiration of your program term. [124.403 (c) (2)]

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CERTIFICATIONS
PARTICIPANT FIRMS OWNED BY INDIAN TRIBES, ALASKA NATIVE CORPORATIONS, NATIVE
HAWAIIAN ORGANIZATIONS OR COMMUNITY DEVELOPMENT CORPORATIONS SHALL CERTIFY
THEY MEET ALL THE 8(a) PROGRAM ELIGIBILITY REQUIREMENTS AS SET FORTH IN 13 CFR
124.112 TO THE EXTENT THAT THEY ARE NOT INCONSISTENT WITH 124.109, 110 AND 111.
PARTICIPANT FIRMS NOT OWNED BY THOSE ENTITIES SPECIFIED ABOVE SHALL CERTIFY THEY
MEET THE REQUIREMENTS OF 13CFR 124.101 THROUGH 124.108.
I CERTIFY THAT ALL INFORMATION SUBMITTED IN THIS 8(a) ANNUAL UPDATE, ATTACHMENTS,
AND THE PERSONAL FINANCIAL STATEMENT IS TRUE, CORRECT AND ACCURATE.

Signature of President, Partner or Proprietor

Date

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Attachment A

INDIVIDUAL COMPENSATION WORKSHEET

Annual Compensation Data: To be provided for each proprietor, partner, officer, director, and each stock holder owning 10% or
more of the company stock. Annual compensation includes all payments, compensation, and distributions, including loans, advances,
salaries and dividends. Each individual reporting must include a signed and dated copy of their most recent tax return, including all
schedules and attachments. In addition, all supporting 1099 forms must be provided. If a filing extension has been requested, provide a
copy of IRS Form 4868, Individual extension request, and a copy of their most recently signed and dated tax return. Tax information
provided may be verified with IRS.[124.112(b)(5)]

Name:

Title:

Ownership %
SBA Customer
Number:

Company Name:
Loans: Does your firm have any outstanding loan(s) to you? Yes
loan.
Source:

No

If yes, please provide the following information for each
Date of Loan:

Status:
Month/Day/Year

Original Amount: $

Balance: $

Terms:

Secured by:
Purpose of Loan:

Annual Compensation:
Salary

$

Bonus(es)

$

Advances

$

Dividends

$

Distributions

$

Other compensation, please specify

$
$
$

Total Compensation for period of

Through
Month/Day/Year

$
Month/Day/Year

Total Compensation for previous year ending

$
Month/Day/Year

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Attachment B

MENTOR/PROTÉGÉ WORKSHEET
Your firm participated in or continues to participate in an any approved mentor/protégé agreement with whom:
Date this agreement was approved:
Is your firm the mentor

or the protégé?

Period of agreement:
? If your firm is the protégé, the following information must be provided. [124.520 (f)]

List all technical and/or management assistance provided by the mentor to the protégé.

List all loans to and/or equity investments made by the mentor in the protégé.

List all subcontracts awarded to the protégé by the mentor and the value of each subcontract.

List all federal contracts awarded to the mentor/protégé relationship as a joint venture (designating each as an 8(a), small business set
aside, or unrestricted procurement), the value of each contract, and the percentage of revenue accruing to each party to the joint venture.

Provide a narrative describing the success such assistance has had in addressing the developmental needs of the protégé and addressing
any problems encountered.

The protégé must annually certify to SBA whether there has been any change in the terms of the mentor protégé agreement. If there
were no changes, please state so, or if there were changes, please indicate.

PLEASE NOTE: The estimated burden for completing this form is 2 hours. You are not required to respond to any collection of information unless it displays a currently valid OMB approval
number. Comments on the burden should be sent to U.S. Small Business Administration, Chief, AIB, 409 3rd St., S.W., Washington D.C. 20416 and Desk Officer for the Small Business
Administration, Office of Management and Budget, New Executive Office Building, Room 10202, Washington, D.C. 20503. OMB Approval (3245-0205). PLEASE DO NOT SEND FORMS
TO OMB.

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