SBA Form 2316 (Par Lender's Supplemental Information for America's Recovery

American's Recovery Capital (ARC) Loan Program

ARC 2316 (Part B) 6-2-09

America's Recovery Capital (ARC) Loan Program

OMB: 3245-0366

Document [doc]
Download: doc | pdf

L

OMB Control No.:

Expiration Date:

MB Approval No.: 3245-0348

Effective Date: 02/19/2004

Expiration Date: 02/28/2007


ENDER’S
Supplemental Information for

America’s Recovery Capital (ARC) Loan Guaranty Request




Borrower Name:



Trade Name (dba):


(if no trade name, enter “NA”)


Borrower Contact:

  • Mr

  • Ms

First


MI


Last



Borrower Street:



Borrower Zip Code:


Borrower Phone #:



Borrower SSN #:


(must include SSN # for principal of borrower)

#

Employer ID #:


(if available)


Borrower State:


(2 letter abbreviation)


Borrower County:


Borrower City:



Lender Name:



Lender ID #:


Loan Maturity:


(in months)


Loan Amount:

$

SBA Guaranty %:

%


Applicant’s Duns #:





Exporter?

Yes

No




  • New Business


  • Outstanding SBA Loan




Rural

  • or

Urban


NAICS Code:



Number of Employees:


Number of Jobs Created:


Number of Jobs Retained:



  • Franchise?

Franchiser’s Name:


SBA USE ONLY:



  • Sole Proprietorship?

  • Partnership?

  • Corporation?

  • Other?






Veteran*

1=Non-Veteran; 2=Veteran-Other; 3=Service-Disabled Veteran; 4=Not Disclosed.

Gender*

M=Male; F=Female; N=Not Disclosed

Race*

1=American Indian or Alaska Native; 2=Asian; 3=Black or African-American; 4=Native Hawaiian or Pacific Islander; 5=White; X=Not Disclosed

Ethnicity*

H=Hispanic or Latino; N=Not Hispanic or Latino; Y=Not Disclosed

Owner #

% Owned

Veteran

Gender

Race

Ethnicity

Please reference the above to

complete this table for each 20% or greater owner of the primary business associated with the borrower. Each block must be completed. More than one race

may be selected.


































* The gender/race/ethnicity/veteran data is collected for statistical purposes only. Disclosure is voluntary and has no bearing on the credit decision.




Borrower Name:




Use of Loan Proceeds

Amount (P&I)

Pay Notes Payable – Trade, etc.*

$

Pay Notes Payable – Mortgage - not Same Institution Debt (SID)

$

Pay Notes Payable – Mortgage - Same Institution Debt (SID)

$

Pay Notes Payable – Secured Lender Debt - not SID

$

Pay Notes Payable – Secured Lender Debt - SID

$

Pay Notes Payable – Unsecured Lender Debt (except credit card debt) - not SID

$

Pay Notes Payable – Unsecured Lender Debt (except credit card debt) - SID

$

Pay Capital Lease

$

Pay SBA Loan made on or after 2/17/09

$

Pay Credit Card Debt

$

Pay Home Equity Loan

$

Total

$



*Notes to vendors, trade, utilities, or other services that are for past due amounts that were converted to a note payable (with or without interest).



Please check all that apply below. You must choose at least one. (Must be completed):


The small business applicant requires an ARC loan due to the following adverse financial condition(s) resulting in immediate financial hardship:


Loss/Reduction of customer base (or loss/reduction of revenue of 20% or more over the preceding 12 months)

Increase in cost of doing business of 20% or more over the preceding 12 months

20% or more loss/reduction of Working Capital and/or loss/reduction of short term Credit Facilities over

preceding 12 months

Decline in Gross Margin of 20% or more over the preceding 12 months

Decline in Operating Ratios of 20% or more over the preceding 12 months

Inability to restructure existing debts due to credit restrictions within the preceding 12 months

Loss/Reduction of Employees

Loss/Reduction of Major Suppliers (major suppliers out of business)

Other Immediate Financial Hardship – Explain:____________________________________________________




Lender Contact:

  • Mr

  • Ms

First


MI


Last



Lender Contact Phone #:


Lender Contact Fax #:






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 15 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 B) 2

File Typeapplication/msword
File Title4-I Supplemental Information for PLP Processing
AuthorKaren Diarra
Last Modified ByJKWhite
File Modified2009-06-02
File Created2009-06-02

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