SBA Form 172 TRANSACTION REPORT ON LOAN SERVICED BY LENDER

OMB Approval No. 3245-0131

SMALL BUSINESS ADMINISTRATION
Expiration Date
TRANSACTION REPORT ON LOAN SERVICED BY LENDER

This form is to be used by Lenders to remit SBA’s share of amounts received from liquidation of loan assets or as payments on loans that have been purchased by SBA.
Reporting of this information is necessary for lenders to comply with SBA loan program requirements and obtain payment on the loan guarantee

1. Mail To:

2. Lender's Name and Address

SMALL BUSINESS ADMINISTRATION
DENVER, CO 80259
3. Loan Number

4. Borrower's Name

5. Interest Rates

6. Participation Percentages
SBA

SBA

Lender

7. Date Repayment Received

8. Installment Due Date Paid

9. Interest Period Paid

10. No. of Days Interest

From:

Lender

To:
11. Application of Repayment:

TOTAL

LENDER SHARE

SBA SHARE

Repayment Amount . . . . . . . . . . . . . . . $
a. To Interest . . . . . . . . . . . . . . . . . . . . $
b. To Principal . . . . . . . . . . . . . . . . . . . . $

$
$
$

$
$
$

Less Recoverable Expenses * . . . . . . . . $

$

$

Less: Service Fee * . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Amount Remitted to SBA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$
$

* Compute Service Fee as follows:
Multiply SBA's Share of Beginning Principal Balance by:
(Number of Days Interest times Daily Factor).
Daily Factor = .0000068 if SBA's Percent ShareExceeds 75%
Daily Factor = .0000103 if SBA's Percent Share is75% or less.
12. Principal Loan Balance:
a.
b.
c.
d.

Last Report (
)
Plus Principal Additions
Less Repayments/Credits
Ending Balance This Report

TOTAL
$
$
$
$

13. Comments: *(Explanation of Recoverable Expenses)

LENDER SHARE
$
$
$
$

14.

SBA SHARE
$
$
$
$

- - - - - - - OFO USE ONLY - - - - - - T/C

Offline Code

Next Due Date
15. Contact Name and Title

16. Telephone No.

Ext

17. Report Date

PLEASE NOTE: The estimated burden hours for the completion of this form is 10 minutes per response. If you have any questions or comments concerning
this estimate or any other aspect of this information collection please contact, Chief, Administrative Information Branch, U.S. Small Business Administration,
409 3rd St., S. W. Washington, D.C. 20416 and OMB Clearance Officer, Paperwork Reduction Project (3245-0131), Office of Management and Budget,
Washington, D.C. 20503. You are not required to respond to this request for information unless it displays a valid OMB approval number and expiration.

SBA FORM 172 (02-2012) REF.: SOP 50-57 PREVIOUS EDITIONS OBSOLETE