SBA Form 2450 Eligibility Information Required for 504 Submission (NON

OMB APPROVAL NO.: 3245-0071

EXPIRATION DATE: X/XX/XXXX

ELIGIBILITY INFORMATION REQUIRED

FOR 504 SUBMISSION (NON PCLP)

[The CDC completes this form to help SBA carryout its lender, portfolio and program oversight as part of the application package for Section 504 Loan and sends to: Sacramento Loan Processing Center, Small Business Administration, 6501 Sylvan Road, Suite 111, Citrus Heights, CA. 95610-5017.]

I. General Information - Fill out all blanks and answer all questions. If a question is answered "No," the loan is not eligible.

Applicant Name ____________________________________________________________________________

CDC Name ____________________________________________________________________________

Describe Type of Business ____________________________________________________________________________

Describe Project ____________________________________________________________________________

Applicant is an operating business organized for profit, is located in United States, has demonstrated a need for

the desired credit, and the desired credit is not otherwise available on reasonable terms from non-Federal sources. YES___NO___

The Applicant will use the Project Property and the Project is located in the United States YES___NO___

The products and/or services of the applicant business are available to the general public. YES___NO___

II. Size - Check Any Item(s) That Are Applicable and Fill out A or B below.

COMPLETE FOR APPLICANT:

1. If using the 504 size standard:

• Tangible net worth of Applicant (excluding its Affiliates) __________________________

• Average net income after Federal income taxes (excluding any

carry-over losses) for the Applicant (excluding its Affiliates) for

the preceding two completed fiscal years __________________________

2. If using the alternative 7(a) size standard:

• Primary industry of Applicant __________________________

• NAICS Code of Applicant __________________________

• Average annual receipts of Applicant Business (excluding affiliates)

over last 3 completed fiscal years __________________________

• No. of employees of Applicant Business __________________________

• SBA size standard for applicant __________________________

___Applicant has possible affiliates. If item is checked, provide the following information in Section X of this form:

List possible affiliates, discuss possible bases of affiliation and determine if affiliation exists.

If affiliation exists, provide a schedule showing combined size calculation.

The combined size calculation of applicant and its affiliates meets the size standard for the

applicant’s primary Industry or the size standard for the primary industry of the applicant and

its affiliates, whichever is higher. YES___NO___

If size standard is exceeded by no more than 25%, Applicant agrees to use the assistance within a labor

surplus area. YES___NO___

___Applicant business has a franchise/license/dealer/jobber or similar agreement. If checked, answer the

following question:

The SBA Franchise Registry lists the franchise/license/dealer/jobber or similar agreements

as an approved agreement. YES___NO___

If “Yes,” attach a Certification of Franchise Documents in Exhibit 13. If “No”, Franchise

Agreement and Franchise Disclosure Statement must be submitted to SLPC with (or prior to) submission of the 504 application

III. Principals of the Applicant - Answer All Questions. If a question is answered "No," the loan is not eligible.

All principals of business are either U.S. citizens, or non-U.S. citizens whose status has been verified by

the lender. YES___NO___

CHOOSE ONE:

______ The business is at least 51 percent owned by individuals who are U.S. citizens and/or who have verified Legal Permanent Resident (LPR) status from USCIS and control the management and daily operations of the business.

______ The business is at least 51 percent owned by aliens with a verified status other than LPR, the lender has determined that continual and consistent management of the business has been provided by a U.S. citizen or by a verified LPR for at least one year and will continue indefinitely AND U.S. collateral is pledged sufficient to pay the loan in full at any time.  (Businesses less than one year old do not meet these requirements.)

No Associate of the Applicant is incarcerated, on probation, on parole, or under indictment for a felony

or a crime of moral turpitude. YES___NO___

IV. Type of Business - Check Any Item(s) That Are Applicable.

___Applicant is or does one of the following: If item is checked, loan is not eligible

• primarily engaged in the business of lending

• a passive business owned by developers or landlords that do not actively use or occupy the assets acquired or improved with the loan proceeds and that is not an Eligible Passive Company discussed below

• bail bond company

• life insurance company

• located in a foreign country or owned by undocumented (illegal) aliens

• pyramid sale distribution plan

• any illegal activity

• principally engaged in teaching, instructing, counseling or indoctrinating religion or religious beliefs, whether in a religious or secular setting.

• consumer or marketing cooperative

• earns 1/3 or more of its gross annual revenue from packaging SBA loans

• derives directly or indirectly more than 5% of its gross revenue through the sale of products or services, or the presentation of any depiction or displays, of a prurient sexual nature or that presents any live performances of a prurient nature

• primarily engaged in political or lobbying activities

• a speculative business (such as oil wildcatting, mining and research & development)

___ Applicant is a business that is primarily engaged in subdividing real property into lots and developing it for resale on its own account or in owning or purchasing real estate and leasing it for any purpose. If checked, loan is not eligible.

___Applicant is a pawn shop. If item is checked, answer the following question. If “No,” loan is not eligible.

More than 50% of Applicant’s income for the previous year was from the sale of merchandise

rather than from interest on loans. YES___NO___

___Applicant is a mortgage service company. If checked, answer the following question. If “No,” loan is not eligible.

Any mortgage loans funded are sold within 14 days of loan closing. YES___NO___

___Applicant is a hotel, motel, recreational vehicle park, trailer park, campground, marina or similar type

of business. If item is checked, answer the following question. If “No,” loan is not eligible.

Applicant derives 50% or more of its gross annual income from transients who stay for periods of time not

exceeding 30 days. YES___NO___

___Any of gross annual revenue of Applicant business is derived from gambling. If item is checked, answer

the following question. If “No,” loan is not eligible.

The revenue is from legal gambling activities and comprises 1/3 or less of gross annual revenue

of Applicant business and the business is not a racetrack, casino or otherwise have gambling as

its reason for being. YES___NO___

___Applicant is a private club or business. If item is checked, answer the following question. If “No,”

loan is not eligible.

Business does not limit the number of memberships for reasons other than capacity. YES___NO___

___Applicant is a government-owned entity. If item is checked, answer the following question. If “No,”

loan is not eligible.

Applicant is business owned or controlled by a Native American tribe, but is a separate legal

entity from the tribe. YES___NO___

___Applicant is an Eligible Passive Company (EPC). If checked, fill in the blanks and answer the following

questions. If an individual question or both parts of a two part question is answered “No,” loan is

not eligible. Attach additional sheet with Names and Legal Forms if more than one OC.

References below to OC mean each OC.

Name of Operating Company (OC) ____________________________________________________________

Legal Form of Entity of OC ____________________________________________________________

• The EPC will use the loans proceeds to acquire or lease, and/or improve or renovate real or personal

property (including eligible refinancing) that it leases 100% to the OCs. YES___NO___

• The OC is an eligible small business and the proposed use of proceeds would be an eligible use if the

OC were obtaining the financing directly. YES___NO___

• The EPC (with the exception of a trust) and the OC each are small under SBA's size standards. YES___NO___

• The EPC is eligible as to type of business, other than being passive. YES___NO___

• The lease between the Eligible Passive Company and the Operating Company will be in writing, will

have a remaining term at least equal to the term of the loan (including options to renew exercisable

solely by the Operating Company), will be subordinated to SBA's lien on the property and the rents

will be assigned as collateral for the loan. YES___NO___

• The OC will be a guarantor or co-borrower. If part of the assets are to be owned by the OC, it will

be a co-borrower. YES___NO___

• Each 20% or more owner of EPC and each 20% or more owner of OC will guarantee loan. YES___NO___

• The debenture amount does not exceed $5.5 million and is to a small manufacturer or the project

meets the public policy goal of at least 10% reduction in Borrower’s energy consumption or meets

the public policy goal of generating renewable energy or renewable fuels.

If “No” please answer the following: YES___NO___

The aggregate amount of the SBA portions for this application and for all outstanding loans to

this applicant, the EPC, the OC and their affiliates do not exceed $5.0 million (or $5.5 million if

the 504 loan is eligible under public policy goals or $5.5 million if the applicant is a Small

Manufacturer). YES___NO___

All outstanding loans include any prior SBA loan guarantees, committed or outstanding, 7(a)

or 504. (Note: If the applicant has a previous small manufacturer or eligibility energy loan it

does not reduce the $5,000,000 limit for regular 504 and Public Policy Project loans.] YES___NO___

• Neither the EPC nor the OC is a trust or SBA requirements regarding trusts are met. YES___NO___

___Applicant is a convalescent or nursing home, or assisted living facility. If item is checked, answer the

following question. If “No,” loan is not eligible.

Applicant is licensed as a nursing home or assisted living facility YES___NO___

V. Project Financing and Costs - Answer All Questions. If an individual question or both parts of a two part

question is answered "No," the loan is not eligible.

Any costs attributable to the Project to be reimbursed to the Applicant are for land that was acquired with

financing for a term of 3 years or less and prior to applying to SBA for the 504 loan and used in the Project, or

for other eligible expenses that are directly attributable toward the Project. YES___NO___

The Interim Loan does not cover the Borrower's contribution. The source of interim financing is not from any

SBA program, directly or indirectly; the terms and conditions of the financing are acceptable; the source is not

the Applicant or an Associate of the Applicant; and the source has the experience and qualifications to monitor

properly all Project construction and progress payments. YES___NO___

The Borrower Contribution is cash or property that is part of the Project Property and is not derived from an

SBA business loan program. If the contribution is borrowed, the interest rate is reasonable and any lien on the

Project assets is subordinate to the liens securing the 504 loan, and the loan will not be repaid at a faster rate

than the 504 loan. YES___NO___

If the Borrower has been in operation for 2 years or less (or there is a change in ownership of the applicant

business)

• There is an additional Borrower Contribution of at least 5% (above the minimum 10%)

• the Debenture will finance no more than 35% of the Project and

• at least 50% of the Project financing will be from state or local government, banks or other financial

institutions, foundations or other not-for-profit institutions, or seller (provided seller subordinates its

interest to the debenture). YES___NO___

If the Project involves a limited or single-purpose building or structure,

• There is an additional Borrower Contribution of at least 5% (above the minimum 10%)

• the Debenture will finance no more than 35% of the Project and

• at least 50% of the Project financing will be from state or local government, banks or other financial

institutions, foundations or other not-for-profit institutions, or seller (provided seller subordinates its

interest to the debenture). YES___NO___

If the Borrower has been in operation for 2 years or less (or there is a change in ownership of the

applicant business) and the Project involves a limited or single-purpose building or structure,

• the Borrower Contribution is at least 20%

• the Debenture will finance no more than 30% of the Project and

• at least 50% of the Project financing will be from state or local government, banks or other

financial institutions, foundations or other not-for-profit institutions, or seller (provided seller

subordinates its interest to the debenture). YES___NO___

The Third Party Loan is at least as much as the 504 Loan (net proceeds). The Third Party Loan(s) has a term

of at least 7 years for a 10 year debenture and at least 10 years for a 20 year debenture. The interest rate is

reasonable. Any financing provided by the seller of Project Property is subordinate to the 504 loan and may

not be prepaid without SBA consent. YES___NO___

No more than 50% of eligible Project costs are from Federal sources. YES___NO___

Any debt consolidation included in the Third Party Loan will not improve the lien position of the Lender on

The pre-existing debt, unless the debt is a previous Third Party Loan. YES___NO___

The debenture amount does not exceed $5.5 million and is to a small manufacturer or the project meets the

public policy goal of at least 10% reduction in Borrower’s energy consumption or meets the public policy goal

of generating renewable energy or renewable fuels. If “No” please answer the following: YES___NO___

The aggregate amount of the SBA portions for this application and for all outstanding

loans to this applicant and its affiliates does not exceed $5.0 million. All outstanding loans also

include any prior SBA loan guarantees, committed or outstanding, 7(a) or 504.) [Note: If the

applicant has a previous small manufacturer or eligibility energy loan it does not reduce the

$5,000,000 limit for regular 504 and Public Policy Project loans.] YES___NO___

VI. Project Economic Development Goals

Answer if debenture amount is $5,000,000 or less:

This Project creates or retains one Job Opportunity for every $65,000 ($100,000 for a small Manufacturer)

guaranteed by SBA. If "No," answer the following question: YES___NO___

The CDC's overall portfolio of 504 loans, including this loan but exclusive of 504 loans to Small Manufacturers

meets or exceeds the CDC's required Job Opportunity Average AND the Project achieves the following

community development or public policy goal: ___________________ If “No”, loan is not eligible.

(A Goal must be cited for any 504 Loan where the above jobs test is not met). YES___NO___

Answer if debenture amount is over $5,000,000 to $5,500,000:

This Project is for a small manufacturer and it creates or retains one Job Opportunity for every $100,000

guaranteed by SBA and the Project achieves the following community development or public policy goal:

___________________ If "No," answer the following question YES___NO___

The project creates or retains one Job Opportunity for every $65,000 guaranteed by SBA or the CDC's

overall portfolio of 504 loans, including this loan but exclusive of 504 loans to Small Manufacturers meets

or exceeds the CDC's required Job Opportunity Average AND it is an Energy Efficiency Project (achieves

the public policy goal of either 10% reduction in energy use or production of renewable energy).

If “No”, loan is not eligible. YES___NO___

VII. Use of Project Proceeds – Check Any Item(s) That Are Applicable.

___To relocate any operations of a small business which will cause a net reduction of one-third or more in

the workforce of the relocating small business or a substantial increase in unemployment in any area of the country.

If item is checked, answer the following questions. If “No,” loan is not eligible.

The relocation is for key economic reasons and crucial to the continued existence, economic wellbeing,

and/or competitiveness of the applicant; and the economic development benefits to the applicant and

the receiving community outweigh the negative impact on the community from which the applicant is

moving. YES___NO___

___To provide or refinance funds used for payments, distributions, or loans to Associates of the Applicant.

If item is checked, loan is not eligible.

___To fund purchase, renovation, or reconstruction of an existing building. If item is checked, answer the

following questions. If “No,” loan is not eligible.

Applicant (or Operating Companies) will occupy at least 51% of the rentable property. YES___NO___

Loan proceeds will not be used to remodel or convert space not occupied by the Applicant or OC. YES___NO___

Third Party Loan proceeds used to renovate the rental space are not counted towards the 504 first

mortgage requirements or the Borrower's Contribution. YES___NO___

___To finance construction of a new building. If item is checked, answer the following questions.

If "No," loan is not eligible. If building will contain rental space, Applicant (or Operating Companies)

will occupy 60% of rentable space immediately, will lease no more than 20% of rentable space long

term, will increase its occupancy within 3 years, and plans to occupy at least 80% of rentable space

within 10 years. YES___NO___

Community improvements do not exceed 5 percent of construction proceeds. YES___NO___

___To purchase, transport, dismantle or install machinery and equipment. If item is checked, answer the

following question. If "No," loan is not eligible.

The machinery and equipment has a useful life of at least 10 years.

(20 years if a 20 year 504 Loan is requested) YES___NO___

___To purchase short-term equipment, furniture and/or fixtures. If item is checked, answer the following question.

If “No,” loan is not eligible.

The dollar amount compared to the total project cost is minimal and will not affect the maturity based

upon a weighted average useful life and the items are essential to and a minor portion of the Project. YES___NO___

___To fund leasehold improvements. If item is checked, answer the following question. If "No," loan is not

eligible. Loan proceeds will be used to improve space occupied 100% by Applicant. YES___NO___

___To acquire, construct, or modify buildings and improvements, and/or to purchase and install machinery and

equipment located on land leased to the Applicant by the CDC or an unrelated lessor. If item is checked, answer

the following questions. If "No," loan is not eligible.

The remaining term of the lease, including options to renew, exercisable solely by the lessee, will equal or

exceed the term of the Debenture, or, in the case of machinery or equipment, equals or exceeds the useful

life of the property or the term of the Debenture, whichever is less. YES___NO___

The Applicant will assign its interest in the lease to the CDC with right of reassignment to SBA. YES___NO___

If CDC is leasing property to the Applicant, the rent paid during the Debenture term will pay principal

and interest on all debt incurred by the CDC to finance the Project, and all related expenses. YES___NO___

___Debt refinance as part of an expansion is included in Project costs: If checked, answer the following questions.

If “No” loan is not eligible.

Total debt refinanced is no more than 50% of new expansion costs; YES___NO___

Either:

1. Substantially all (85% or more) of the proceeds of the existing debt was used to acquire

land, including a building situated thereon, to construct a building thereon or purchase equipment

and the remaining amount (15% or less) was incurred for the benefit of the small business

seeking the refinancing; or YES___NO___

2. If the land, building or equipment was originally financed through a commercial loan

(hereafter the “original loan”) that was subsequently refinanced one or more times:

1. Substantially all (85% or more) of the proceeds of the original loan was used to

acquire land, including a building situated thereon, to construct a building thereon or

purchase equipment and the remaining amount (15% or less) was incurred for the

benefit of the small business seeking the refinancing; and YES___NO___

2. The existing debt is the most recent refinancing of the original loan;

3. The existing indebtedness is collateralized by fixed assets; YES___NO___

4. The existing indebtedness was incurred for the benefit of the small business concern; YES___NO___

5. Project proceeds will be used only for refinancing existing indebtedness or costs relating

to the project financed; YES___NO___

6. The financing will provide a substantial benefit to the borrower when prepayment penalties,

financing fees, and other financing costs are accounted for; YES___NO___

7. The borrower has been current on all payments due on the existing debt for not less than

1 year preceding the date of refinancing; YES___NO___

8. The financing under section 504 will provide better terms or rate of interest than

the existing indebtedness at the time of refinancing; YES___NO___

9. No debt refinanced is due to an Associate of applicant; YES___NO___

10. No debt refinanced is due to a Small Business Investment Company; YES___NO___

11. No creditor whose debt is refinanced is in a position to sustain a loss causing a shift

of any part of a potential loss to SBA. YES___NO___

___Loan proceeds will affect properties included or eligible to be included in the National Register of Historic Places.

VIII. Conflict of Interest

SBA may not provide financial assistance to an applicant where there is any appearance of a conflict of interest on the part of SBA or the CDC.

A) All statements must be answered as “True” to be eligible.

• If an Associate** of the small business or member of any Associate’s household is a GS-13 or higher government

employee or a Major or Lieutenant Commander or higher in the military, the small business applicant has submitted

to the CDC a statement of no objection by the pertinent government department or military service. True____

• No officers or directors of community organizations such as certified development companies and microlenders or

members of their household have a direct or indirect financial or other interest in the Applicant unless the organization has been inactive in packaging SBA loans for at least two years prior to the application date. True____

• No CDC or Associate** of CDC has a real or apparent conflict of interest with Applicant, any of Applicant’s

Associates, or any of the close relatives of Applicant’s Associates. True____

• No CDC or Associate or close relative of an associate of the CDC has a direct or indirect financial or other

interest in the applicant, or has had such an interest within 6 months prior to the date of the application. True____

• No Associate of a CDC is incarcerated, on parole, or on probation or is a convicted felon or has an adverse final

civil judgment (in a case involving fraud, breach of trust, or other conduct) that would cause the public to question

the CDC’s business integrity. True____

• No CDC or any Associate of CDC has accepted funding from a source that restricts, prioritizes, or conditions the types

of small businesses that CDC may assist under an SBA program or that imposes any conditions or requirements upon

recipients of SBA assistance inconsistent with SBA’s loan programs or regulations. True____

• None of the Loan proceeds will directly or indirectly finance purchase of real estate, personal property or services

from CDC or an Associate of CDC. True____

• Neither the Applicant, an Associate of Applicant, close relative nor household member of an Associate of Applicant

is required to invest in CDC. True____

• None of the proceeds of the loan will be used to acquire space in project for which CDC has issued a real estate forward

commitment. True____

B) Check any item(s) that are applicable. If checked, SBA Standards of Conduct Committee approval will be required prior

to issuance of an SBA loan authorization.

___SBA employee, the employee’s close relative or a member of the employee’s household is an employee, officer,

director, attorney, agent, creditor or debtor, or has a financial interest in the Applicant.

___Former SBA employee separated from SBA for less than one year is an employee, officer, director, attorney, agent,

creditor or debtor, or has a financial interest in the Applicant.

___Member of Congress or an appointed official or employee of the legislative or judicial branch (or a close relative or

household member of such an individual) is a sole proprietor, general partner, officer, director, employee, attorney,

agent, creditor or debtor, or has a financial interest in the Applicant.

___Member or employee of a Small Business Advisory Council or a SCORE volunteer (or a close relative or household

member of such an individual) is a sole proprietor, general partner, officer, director, employee, attorney, agent, creditor

or debtor, or has 10.0% or more financial interest in the Applicant.

___Employee of community organizations such as a certified development companies or microlenders (or a close relative

or household member of such an individual) has a financial interest in the Applicant.

(**Associate of a CDC is an officer, director, key employee, or holder of 20 percent or more of the value of the CDC’s stock or debt instruments or an agent involved in the loan process. An Associate of a small business is an officer, director, owner of more than 20 percent of the equity, or key employee.)

IX. Other - Check Any Item(s) That Are Applicable.

___Applicant or Affiliate(s) has/have existing SBA loan(s). If item is checked, answer the following question.

If "No," loan is not eligible.

The existing SBA loan(s) is/are current. YES___NO___

___Business or any of its principals has been involved in a federal loan or federally assisted financing that

defaulted and caused a loss to the Federal government or any of its Departments or agencies.

(If “Yes,” explain in Section X.) YES___NO___

___Applicant business is principally engaged in teaching, instructing, counseling, or indoctrinating religion or religious

beliefs whether in a religious or secular setting. (If “Yes,” explain in Section XI.) YES___NO___

___Applicant has products or services of a prurient sexual nature. If item is checked, answer the following questions.

If "No," loan is not eligible

Applicant does not present live performances of a prurient sexual nature. YES___NO___

Applicant does not derive more than 5% of its gross revenue directly or indirectly, through the sale of

products or services or the presentation of any depictions or displays of a prurient sexual nature. YES___NO___

___Applicant conducts operations both in the United States and in a foreign country. If item is checked,

answer the following questions. If "No," loan is not eligible

Applicant operates primarily in the United States. YES___NO___

Applicant pays taxes to the United States OR applicant uses American products, materials, and labor. YES___NO___

Loan proceeds will be used exclusively for the benefit of the domestic operation. YES___NO___

Applicant does not conduct trade in any country with which the United States Government restricts trade

according to the Export-Import Bank’s current “Country Limitation Schedule” (CLS), which can be

found at http://www.exim.gov/tools/country_limits.html YES___NO___

___Loan is collateralized by Indian lands held in trust. YES___NO___

X. COMMENTS REGARDING ANY OF ABOVE ANSWERS THAT REQUIRE EXPLANATION OR REGARDING ANY OTHER RELEVANT ELIGIBILITY ISSUES. ATTACH ADDITIONAL PAGE(S) IF NECESSARY.

CDC hereby certifies that the above information is true and correct, to the best of its knowledge, and that it has exercised due diligence to obtain the true and correct information.

CDC Signature

and Typed Name and Title _________________________________ Date ___________________________________

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. 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.

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SBA Form 2450 (2-14) Previous Editions Obsolete