SBA Form 2316 (Par America's Recovery Capital (ARC) Loan Guaranty Request

OMB Control No.:

Expiration Date:

America’s Recovery Capital (ARC) Loan Guaranty Request

(For non-delegated lender submissions)

TO: Standard 7(a) Loan Guaranty Processing Center (LGPC)

Small Business Administration

6501 Sylvan Road

Suite 122 

Citrus Heights Ca 95610-5017

RE: Applicant Name__________________________________________________________

Operating Company (OC) Name (If Applicant is an Eligible Passive Company)________________

_____________________________________________________________________________________

(If more than one OC, attach additional sheet with all OC names)

FROM: Lender__________________________________________________________________

Contact_________________________________________________________________

Address_________________________________________________________________

Phone____________________________FAX__________________________________

The following items are enclosed:

[ ] 1. Copy of “Supplemental Information for America’s Recovery Capital (ARC) Loan Guaranty Request” (Part B)

[ ] 2. Original or facsimile of “Eligibility Information Required for America’s Recovery Capital (ARC) Loan Submission” (Part C)

I approve this application to SBA subject to the terms and conditions stated in this and the attached documents. Without the participation of SBA, to the extent applied for, we would not be willing to make this loan on these terms, and in our opinion the financial assistance approved is not otherwise available on reasonable terms. I certify that none of the Lender’s Associates, including but not limited to its employees, officers, directors, or substantial stockholders (more than 10%) has a financial interest in the Applicant. I approve and certify that the Applicant is a small business according to the standards in 13 CFR Section 121, the loan proceeds will be used for an eligible purpose, and the owners and managers of the applicant business are of good character.

Approving/Certifying Lender Official:

_____________________________________________ _______________________

(Signature) Date

_____________________________________________

Type or Print Name and Title

NOTE: According to the Paperwork Reduction Act, you are not required to respond to this collection of information unless it displays a currently valid OMB Control Number. The estimated burden for completing this form, including time for reviewing instructions, gathering data needed, and completing and reviewing the form is 5 minutes per response. Comments or questions on the burden estimates should be sent to U.S. Small Business Administration, Chief, AIB, 409 3rd St., SW, Washington DC 20416. PLEASE DO NOT SEND FORMS TO THIS ADDRESS.

SBA Form 2316 (Part A)