Sba Form 2181 Excel Supplement

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Overview

Cover
Table of Contents
Summary
Info Release
1. Investment Strategy
2.1 Firm & Team
2.2 Firm & Team
2.3 Firm & Team
2.4 Firm & Team
2.5 Firm & Team
3. Investment Process
5.1 Fund Economics
5.2 Fund Economics
5.3 Fund Economics
6.1 Capitalization
6.2 Capitalization
6.3 Capitalization

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Sheet 1: Cover

									OMB Approval No. 3245-0062
									Expiration Date: MM/DD/YYYY
				409 3rd St., SW • Washington, DC 20416 • (202) 205-6510
				The SBIC Program
				Form 2181: Excel Supplement
	Name of Applicant:		Name of Applicant, LP
	If Applicable:
	Counsel (Law Firm):		SBIC Attorneys, LLP
	Counsel (Attorney):		Larry Lawyer
	Principals:		Jon Doe
Data Entry Instructions:
	Input		Yellow cells with blue text are input cells. Enter data in these cells only.
	Do Not Edit		White cells with black text contain formulas. Do not edit these cells.
	Edit if Needed		Blue cells contain formulas, but you may delete these and enter your own values.
	50000000		Enter all numbers to nearest dollar…
	▼
	$50 M		…the spreadsheet will automatically display your entry in the appropriate format.
The estimated combined burden for completing this form and Form 2181: Excel Supplement is 33 hours per response. 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 the US Small Business Administration, Chief, Administrative Information Branch, Washington, DC 20416 and Desk Officer for the Small Business Administration, Office of Management and Budget, New Executive Office Building, Room 10202, Washington, DC 20503. OMB Approval 3245-0062.
Please do not send forms to OMB. Refer to Instructions for information on how and where to submit the requested information.
SBA Form 2181 (07-13) Previous editions obsolete

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Sheet 2: Table of Contents

Table of Contents
Overview
		Summary
		Info Release
Investment Strategy
1.		Investment Strategy
Firm & Team
2.1		Firm & Team: Firm Profile & Service Providers
2.2		Firm & Team: Principal Information
2.3		Firm & Team: Time Dedication
2.4		Firm & Team: Team History
2.5		Firm & Team: Staffing Chart
Investment Process
3.		Investment Process
Fund Economics
5.1		Fund Economics: Distribution Waterfall
5.2		Fund Economics: Fund Terms
5.3		Fund Economics: Licensing Expenses
Capitalization
6.1		Capitalization: Fundraising Expectations & Capital Sources Summary
6.2		Capitalization: Capital Sources
6.3		Capitalization: Placement Agents

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Sheet 3: Summary

Name of Applicant, LP
#VALUE!
Table of Contents
Summary Table
In the table below, please list the names of any person or entity which has a carried interest in the profits of the SBIC (parent if a drop-down), general partner, or management entity. List the Principals of the fund first followed by any other individuals or entities. For any non-Principals being allocated carried interest, list them by name, entity or category (such as "Employees" or "Carry Reserve") and provide the remaining requested information if available/relevant.
Name	Carry Points	LP Contribution (% of Priv. Cap.)	Salary/Bonus	Time Commitment to SBIC (%)	Investment Committee (Y/N)
Jane Doe	5	0.20%	$250k/$50k	90%	Y

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Sheet 4: Info Release

Name of Applicant, LP
#VALUE!
Table of Contents
Authorization to Release Information to Interested Investors
From time to time, the SBIC Program receives inquiries from parties who may wish to consider investing in an SBIC license applicant. Information is shared ONLY for those applicants that have received a "green light" letter. If your fund receives a "green light" letter and you would like SBA to share your fund's name, contact information and target fund size with interested investors, please make an indication below. If no indication is made, SBA will NOT share your information with interested investors. The information in the fund profile below is being pulled from other parts of this workbook. However, you are welcome to edit the profile on this page as you see fit.
				Yes, we authorize SBA to share the information included on THIS PAGE ONLY with interested investors
				No, we do not authorize SBA to provide information about our fund to interested investors
Fund Profile for Release:
Applicant Name:	[Name of Applicant, LP]
Contact Person:	Jon Doe
Main Phone:	0
Main E-mail:	0
Website:	0
Target Fund Size:	$50 M

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Sheet 5: 1. Investment Strategy

Name of Applicant, LP
#VALUE!
Table of Contents
Portfolio Profile						Target Transaction Profile & Portfolio Profile Cont.
Select the "Strategy Type" that best categorizes your proposed SBIC. In the tables that follow, please indicate how your invested capital will be distributed across industry sectors, geographies, etc. Select the relevant label and enter your best estimate of the percent of invested capital. Rank each table from highest area of concentration to lowest. SBA will treat these as estimates-only and you will not be required to maintain these precise allocations upon licensing. Drop-down menus have been provided, but where permitted and as necessary, you may type-in your own categories.						Using the table below, please indicate the characteristics of your target portfolio company profile. Also provide your expectations of your deal flow, investment pacing, the return range for each type of investment security you expect to use, the hold periods and indicate whether you intend to reinvest proceeds from your investments.
Strategy Type: (Scroll down to see "Strategy Type" definitions)								Minimum	Maximum
						Target Revenue Range:		$25 M	$100 M
Industry	%		Exit Mechanism	%		Target EBITDA Range:		$5 M	$10 M
Telecommunications	50%		Distressed Exit	60%		Target Leverage (Total Debt/EBITDA):		4.0x	6.0x
Data Processing, Hosting, and Related Services	50%		Sale/Merger	20%
			IPO	20%				Low	High
						Percentage of Deals w/Sponsors:		20%	30%
						Business Plans Review per Year (Est.):		500
Other			TOTAL:	100%		% of Business Plans Invested:		10%
TOTAL:	100%
			Portfolio Mix (Defined in 13 CFR 107.800-815)	%		Total Number of Portfolio Companies:		15
Geography	%		Equity	100%		Average Deal Size:		$10 M
West	75%		Debt	0%		Years to full Deployment:		5
Southwest	20%		Loans	0%		Capital Invested per Year:		$5 M
Northeast	5%		TOTAL:	100%
						Reinvestment of Proceeds:		Yes
			Investor Role	%
			Sole	60%		Return Range (%):		IRR Min.	IRR Max.
Other			Lead Investor	20%		Equity		25%	30%
TOTAL:	100%		Co-/Minority Investor	20%		Debt		12%	14%
			TOTAL:	100%		Loans		9%	12%
Stage of Investment	%
Seed	80%					Estimated Hold Periods (Years)		Min.	Max.
Early	20%					Equity		7	10
						Debt		3	5
						Loans		5	7
Other
TOTAL:	100%
Strategy Type Definitions
Venture: Seed Stage		Funds that make a majority of their investments in newly formed companies thereby helping to help a company's founders to research, develop and design a product or service. This stage involves a relatively small amount of capital and is a typically a pre-marketing stage.
Venture: Early Stage		Funds that make a majority of their investments in companies that have a product development, initial marketing, manufacturing and sales activities already in testing or production. The investments are used by the company to begin production and sales. In some cases, the product may have just been made commercially available. These companies may not yet be generating profits. The companies may be in the process of organizing or they may already be in business for three years or less. Usually such firms will have made market studies, assembled the key management, developed a business plan, and are ready or have already started conducting business.
Venture: Later Stage		Funds that make a majority of their investments into portfolio companies that have an already established product or service that has, and have already generated revenue, but may not be making a profit. These companies may need capital to grow or expand. The investments are used to increase marketing, production capacity, further product development, etc. Later Stage Funds make the last round of investments in portfolio companies before an exit in the form of an IPO or acquisition by a strategic partner.
Venture: Balanced		Funds whose investment focus is a Multi-Stage (Balanced) focus in Venture Capital. These funds' investment activities include Seed Stage, Early Stage and/or Later Stage investing with no particular concentration on either.
Buyout		Funds that make leveraged buyout, management buyout or acquisition investments. These funds use debt in addition to equity to leverage the size of their investments and increase the potential return on investment. This stage would also include funds making infrastructure investments.
Buyout: Turnaround/Distressed Debt		Funds that invest in underperforming companies. Turnaround Funds may use both debt and equity to invest in companies and employ a variety of tactics to improve profitability and increase revenue. Distressed Debt Funds make investments in companies that are in bankruptcy proceedings or already bankrupt. These funds purchase outstanding debt from a company at a discount. Most distressed debt funds that are managed by private equity firms make controlled debt investments, meaning they take an active seat on the company board or a management position within the company. Restructuring Funds are funds that invest in companies that have a large amount of debt, are in default of creditors, have insufficient liquidity or lack capital assets. The funds look to restructure or eliminate these liabilities for the company. Recap Funds are funds that make investments that include a reorganization of a company's capital structure. Often Recap Funds will sell off non-essential assets, or pay down debt that a company owes.
Mezzanine		Funds that invest using a type of debt financing that has intermediate priority in the capital structure of a company. For example, mezzanine debt has lower priority than senior debt but usually has a higher interest rate and often includes warrants. In venture capital, a mezzanine round is generally the round of financing that is designed to help a company have enough resources to reach an IPO.
Senior Credit/Credit		Funds that invest using senior debt instruments with a first or second lien on assets and which are senior to the type of subordinated debt often deployed by "Mezzanine" funds. Senior Credit/Credit strategies include asset-based lending strategies and venture lending strategies, among others.
Generalist		Funds whose investment focus is both Venture Capital and buyout investing. These funds can invest in all stages of Venture Capital and Buyouts.

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Sheet 6: 2.1 Firm & Team

Name of Applicant, LP

#VALUE!

Table of Contents

Firm Information

Enter the requested information. Select from the drop-down menu where available. The EIN should be provided for the fund entity and is required for inclusion in License Applications only, though you may provide it as part of your MAQ submission if it is available.

Full Legal Name of Fund

EIN (Required for License App only)

Applicant Type

MAQ Submission Date

Licensing Submission Date

Main Telephone

Main E-mail

Website

[Name of Applicant, LP]

0

0

0

0

0

Address 1

Address 2

City

State

ZIP Code

Country

Headquarters:

Branch Offices (if any):

Service Providers

Please use the table below to list any law firms, accounting firms or consultants you are currently employing or any firm that will be compensated for assisting you in any manner to obtain an SBIC license. If a person, group or entity has made any contributions (whether financial or non-financial) that entitle it or them to any type of equity or economic participation in the SBIC, very briefly describe the nature of such contribution.

Firm Name

Firm Type

City

State

Key Contact

Phone

E-mail

Description of Contribution (If applicable)

SBIC Attorneys, LLP

Law

Accounting

Consultant

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Sheet 7: 2.2 Firm & Team

Name of Applicant, LP

#VALUE!

Table of Contents

x

Principal Information

x

Enter the requested information for the Principals of the fund ONLY, beginning with the Principal serving as the applicant's primary contact with SBA. For the purposes of the SBIC application process, the term "Principal" refers to any individual who engages or proposes to engage in the management of the applicant, and customarily includes officers and directors of a corporation, general partners of a partnership, and managers of a limited liability company. However, it may also include other individuals, especially if they have a vote or a veto in the investment decision-making process.

x

Full First Name

Full Last Name

Nickname

U.S. Citizen (Y/N)

Permanent Resident Alien (Y/N/NA)

Business Telephone

Business E-mail

Business Address 1

Business Address 2

Business City

Business State

Business ZIP Code

Business Country

Home Address 1

Home Address 2

Home City

Home State

Home ZIP Code

Home Country

Mobile Telephone

Personal E-mail

x

Jon

Doe

Jon

Y

NA

(999) 999-9999

[email protected]

409 3rd St., SE

Suite 6300

Washington

DC

200416

USA

123 ABC St.

Apt 987

Nowhere

CA

12345

USA

(123) 456-7890

[email protected]

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Sheet 8: 2.3 Firm & Team

Name of Applicant, LP

#VALUE!

Table of Contents

Time Dedication to SBIC

Time Dedication: SBIC Activities

Select the last name of each principal using the drop-down menu provided in the table below. Adjust the number of rows, if necessary. For each principal, estimate the percentage of time devoted to the SBIC at each of the three time intervals: 90 days after licensing, 18 months after licensing and in subsequent years.

Select the name of each principal using the drop-down menu provided in the table below. Adjust the number of rows, if necessary. For each principal, indicate how the time he/she will dedicate to the SBIC will be distributed across the various activities listed. Each row should sum to 100%.

Principal Last Name

90 Days after Licensing

18 Months after Licensing

Subsequent Years

Principal Name

Deal Sourcing

Deal Execution

Portfolio Monitoring

Operations

Marketing

Investor Relations

Administration

Total

Doe

20%

Doe

0%

<--- Insert additional rows, as necessary

x

x

x

x

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Sheet 9: 2.4 Firm & Team

Name of Applicant, LP
#VALUE!
Table of Contents
Team History
Please use the table below to list the Principals' experience working together. List common work experience in chronological order based on the year the activity began. Use the examples as a guide.
Names of Principals	Company Name or Business Entity	Type of Business	Starting Year	Ending Year
John Doe, Mary Washington	Small Business Bankers	Investment Bank	1992	1998
William J. Bryan, Paul Revere	WP Consulting	Management Consulting	1995	1997
John Doe, William J. Bryan	SBIC Investors, LP	Private Equity Fund	1998	2004
John Doe, William J. Bryan, Mary Washington	SBIC Investors, LP	Private Equity Fund	2005	2008
John Doe, William J. Bryan, Mary Washington, Paul Revere	SBIC Investors, LP	Private Equity Fund	2009	Present

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Sheet 10: 2.5 Firm & Team

Name of Applicant, LP
#VALUE!
Table of Contents
Staffing Chart
Complete the following table for the management entity of the SBIC, whether a separate company or the GP of the SBIC if there is not an external advisor/manager. The table should reflect the management team at its peak staffing level and include the Principals, junior members of the investment team, back office personnel and any other individuals receiving compensation. Make sure to indicate which staff member (principal or employee) will perform the function of CFO. If this person is not a full-time hire, enter their title as "CFO (Part-Time)." If you have not yet hired a CFO, follow the guidance below regarding unfilled positions. However, if an individual has been identified prior to the submission of your License Application, please note that this person may be required to provide the relevant exhibits identified in Form 2182: Principal Exhibits - Exhibit G. For positions that have not yet been filled, please leave the "Name" field blank and enter the position title, salary and other requested information. In the "No." column, enter the number the firm anticipates hiring. In the "ID'd" column, enter the number of candidates the firm has identified but not yet hired.
Name	Title	Salary	Bonus	City	State	No.	ID'd
John Doe	Managing Director	$250,000	$50,000	Chicago	IL
Susan Anthony	CFO (Part-Time)	$60,000		New York	NY	1
	Associate	$120,000	$12,000	New York	NY	2	1

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Sheet 11: 3. Investment Process

Name of Applicant, LP
#VALUE!
Table of Contents
Consultants Utilized
Complete the following table for any consultants utilized as part of the due diligence process for any deal completed within the last five (5) years.
Firm Name	Area of Expertise	Contact Person	Telephone	E-mail	City	State	% of Past Deals Utilized	% of Future Deals Anticipated

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Sheet 12: 5.1 Fund Economics

Name of Applicant, LP
#VALUE!
Table of Contents
Distribution Waterfall
Using the space below, or in a separate spreadsheet, provide a mathematical example of your fund's distribution waterfall

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Sheet 13: 5.2 Fund Economics

Name of Applicant, LP
#VALUE!
Table of Contents
SBIC Fund Terms
Indicate the details of the management fee that will be charged as well as the distribution of the GP carry. Please note that SBA provides guidance on the maximum allowable management fees permitted in Tech Note 7A (available online at: www.sba.gov/inv)
Management Fee:
Investment Period:
Fee Base:	Private Capital & SBA Commitments
Period (Years from Inception):	5
Fee:	2.5%
Harvest Period:
Fee Base:	Assets Under Management
Period (Subsequent Years):	5
Fee:	1.5%
Carry Distribution Table:
Principals	Pts.	Others	Pts.
				<--- Insert additional rows above this line, as needed
TOTAL:	0	TOTAL:	0
TOTAL Carried Interest Pts:	0

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Sheet 14: 5.3 Fund Economics

Name of Applicant, LP
#VALUE!
Table of Contents
Licensing Expenses
Summarize the projected and/or incurred organizational expenses and Management Expenses you expect to incur in connection with obtaining a license, and through the entire licensing process. If the amounts listed are formula-based, provide the formula and leave the amounts blank.
Source	Amount Paid	Amount Accrued	Total Projected	Formula (if applicable)
Legal	$125,000
Accounting
Consulting
Placement
License Fee
Organizational
Management Expenses
Other
TOTALS:	$125,000	$0	$0

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Sheet 15: 6.1 Capitalization

Name of Applicant, LP

#VALUE!

Table of Contents

Fundraising Expectations

Capital Sources (Summary)

Complete the tables below with information concerning your fundraising expectations

The tables below summarize the information entered in the next worksheet. Do Not Edit this table.

MAQ

Tiers of SBA Leverage Requested:

2.0x

Investor Type

Current

Forecast

Principal

$0.75 M

$1.05 M

Private Capital Raise:

Amt. ($)

Fund Total

Entity Institutional Investor

$0.00 M

$28.00 M

Minimum to close:

$25 M

$75 M

Individual Institutional Investor

$0.00 M

$24.00 M

Maximum accepted:

$75 M

$225 M

Other

$0.00 M

$0.00 M

Target/Likely:

$50 M

$150 M

TOTAL:

$0.75 M

$53.05 M

% Foreign

0%

11%

Closing Dates & Capital:

First

Final

Anticipated (mm/yyyy)

12/13

06/14

MAQ

Actual (mm/yyyy)

Investor Type

Current

Forecast

Total Capital at Close ($):

$30 M

Principals

100%

2%

Entity Institutional Investor

0%

53%

Individual Institutional Investor

0%

45%

Others

0%

0%

TOTAL:

100%

100%

Capital Reserves

Use the table below to indicate the amount of capital you anticipate will be held in reserve at the end of your investment period for follow-on financings, management expenses or other contingencies.

Private

Leverage

Total

Target capital raise:

$50 M

$100 M

$150 M

Percentage held in reserve:

10%

10%

10%

TOTAL Capital Reserves:

$5 M

$10 M

$15 M

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Sheet 16: 6.2 Capitalization

Name of Applicant, LP
#VALUE!
Table of Contents
Capital Sources
Use the table below to indicate the amount of capital raised as of your application submission date as well as your forecast of future fundraising results. The list should be ranked from the most secure capital committments to the least secure. Begin with the names of any individual or entity investors that have made "hard" commitments to the fund. Next select their "Investor Category" from the drop-down menu, select "hard circle" from the Commitment drop-down menu, indicate whether or not the investor is a Foreign Investor, then provide the dollar value of their committment in the "Current" column. Once you have listed all of the "hard" commitments made to the fund, list the names of any investors that have made "soft" committments to the fund and enter the dollar value of their commitment in the "Forecast" column. Finally, provide an estimate of any additional commitments you expect to raise from any of the four Investor Categories. Use one row for each Investor Category. Under "Investor Name," enter "N/A", select the relevant "Investor Category" and provide the dollar value of the additional commitments to be raised in the "Forecast" column.
					MAQ
Investor Name	Investor Category	Commitment	Foreign (Y/N)		Current	Forecast
John Doe	Principal		N		$0.15 M	$0.45 M
Peter Partner	Principal		N		$0.35 M	$0.35 M
Carrie D'Intrast	Principal		N		$0.25 M	$0.25 M
H.N. Worth	Individual Institutional Investor		Y			$6.00 M
The Doe Family Office	Entity Institutional Investor		N			$10.00 M
N/A	Entity Institutional Investor		N			$18.00 M
N/A	Individual Institutional Investor		N			$18.00 M
							<--- Insert additional rows above this line, as needed
x	x	x		x	x	x

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Sheet 17: 6.3 Capitalization

Name of Applicant, LP
#VALUE!
Table of Contents
Placement Agents
Complete the following table for any placement agents hired to assist with the fund's fundraising efforts. Also provide a list of investors the placement agent has successfully suscribed to the fund.
Placement Agent Information:
Firm Name	Contact Person	Telephone	Email	City	State	Placement Fees Paid to-Date
						$1,250
Investors Subscribed to-Date:
Investor Name	Subscription Amount
	$1,250
TOTAL:	$1,250