**ADDENDUM TO ELA**
The following information is provided to ELA Applicant prior to submitting online application.
Please note SBA/ODA is in the process of updating the ELA to incorporate the revised pages from the paper form.
U.
S. Small Business Administration
DISASTER
BUSINESS LOAN APPLICATION
This form is for use by
Businesses to apply for an SBA physical or economic injury disaster
loan as applicable. The requested information is required to obtain
a benefit under our SBA Disaster Loan Program and helps the Agency
determine whether the applicant is eligible for a disaster loan and
has repayment ability.
If you have questions about this
application or problems providing the required information, please
contact our Customer Service Center at 1-800-659-2955 or
[email protected].
If more space is needed for any section of this application, please
attach additional sheets. SBA will contact you by phone or E-mail to
discuss your loan request.
You may submit the form: Online
on SBA's secure website
www.sba.gov In-person
at a disaster
center, By
Mail:
U.S.
Small
Business
Administration,
Processing
and
Disbursement
14925
Kingsport
Rd.
Ft.
Worth,
TX
76155-2243 SBA
will contact you by phone or email to discuss your loan request
FOR
ALL APPLICATIONS, EXCLUDING NON-PROFIT ORGANIZATIONS, THE FOLLOWING
ITEMS MUST
BE
SUBMITTED.
This application (SBA Form 5),
completed and signed
Request for Transcript of Tax
Returns (IRS Form 4506C), completed and signed by each applicant,
each principal owning 20 percent or more of the applicant business,
each general partner or managing member; and, for any owner who has
greater than 50 percent ownership in an affiliate business.
Affiliates include, but are not limited to, business parents,
subsidiaries, and/or other
businesses with common ownership or management
Complete copies, including all
schedules, of the most recent Federal income tax returns for the
applicant business; an explanation if not available
Personal Financial Statement
(SBA Form 413) completed, signed, and dated by the applicant, each
principal owning 20 percent or more of the applicant business, and
each general partner or managing member
Schedule of Liabilities listing
all fixed debts (SBA Form 2202 may be used) NON-PROFIT
ORGANIZATIONS (including
Houses of Worship, Associations, etc), THE
FOLLOWING ITEMS MUST BE
SUBMITTED: This
application (SBA Form 5), completed and signed
A complete copy of the
organization's most recent tax return OR
a copy of the
organization’s IRS tax-exempt certification and complete
copies of the organization's three most recent years' "Statement
of Activities" Schedule
of Liabilities.
Request for Transcript of Tax
Returns (IRS Form 4506C), completed and signed by each applicant and
for any affiliated entity. Affiliates include, but are not limited
to, business parents, subsidiaries, and/or other businesses with
common ownership or management. ADDITIONAL
REQUIREMENTS FOR MILITARY RESERVIST ECONOMIC INJURY (MREIDL);
A copy of the essential
employee’s notice of expected call-up to active service (as
defined in 10 U.S.C. 101(d)(3)) for a period of more than 30
consecutive days or official call-up orders, or release/discharge
from active service
A written explanation and
financial estimate of how the call-up of the essential employee has
or will result in economic injury to your business, and the steps
your business is taking to alleviate the economic injury MREIDL
Certification Form P-0002, which includes: -Your
statement that the reservist is essential to the successful
day-to-day operations of the business -Your
certification
that
the
essential
employee
will
be
offered
the
same
or
a
similar
job
upon
the
employee's
return
from
active
service
-The essential employee's
concurrence with your statements ADDITIONAL
INFORMATION MAY BE NECESSARY TO PROCESS YOUR APPLICATION. IF
REQUESTED,
PLEASE
PROVIDE WITHIN 7 DAYS OF THE INFORMATION REQUEST; Complete
copy, including all schedules, of the most recent Federal income tax
return for each principal owning
20 percent or more, each general
partner or managing member, and each affiliate when any owner has
more than 50 percent ownership in the affiliate business. Affiliates
include, but are not limited to, business parents, subsidiaries,
and/or other businesses with common ownership or management
If the most recent Federal
income tax return has not been filed, a year-end profit-and-loss
statement and balance sheet for that tax year A
current year-to-date profit-and-loss statement
Additional Filing Requirements
(SBA Form 1368) providing monthly sales figures for will generally
be required when requesting an increase in the amount of economic
injury.
SBA
Form 5 (XX-XX) Ref SOP 50 30
Page 1 of 3
NOTE: PLEASE READ, DETACH AND
KEEP FOR YOUR RECORDS STATEMENTS
REQUIRED BY LAWS AND EXECUTIVE ORDERS
To comply with legislation passed by the Congress and Executive
Orders issued by the President, Federal executive agencies,
including the Small Business Administration (SBA), must notify you
of certain information. You can find the regulations and policies
implementing these laws and Executive Orders in Title 13, Code of
Federal Regulations (CFR), Chapter 1, or our Standard
Operating Procedures
(SOPs). In
order to
provide the
required notices,
the following
is a
brief summary
of the
various laws
and Executive
Orders that
affect SBA's
Disaster Loan
Programs. A
glossary
of terms
can be
found at
Disasterloanassistance.sba.gov.
FREEDOM OF INFORMATION ACT (5 U.S.C. 552)
This law provides, with some exceptions, that we must make records
or portions of records contained in our files available to persons
requesting them. This generally includes aggregate statistical
information on our disaster loan programs and other information
such as names of borrowers (and their officers, directors,
stockholders or partners), loan amounts at maturity, the collateral
pledged, and
the general
purpose of
loans. We
do not
routinely make
available to
third parties
your proprietary
data without
first notifying
you, required by Executive Order 12600, or confidential business
information, information that would cause competitive harm, or
information that would constitute a clearly unwarranted invasion of
personal privacy.
For information about the FOIA, contact the Chief, FOI/PA Office,
409 3rd Street, SW, Suite 5900, Washington, DC 20416, or by e-mail
at
PRIVACY ACT (5 U.S.C. 552a)
Anyone can request to see or get copies of any personal information
that we have in your file. Any personal information in your
file that
is retrieved
by individual
identifiers, such
as name
or social
security number,
is protected
by the
Privacy Act,
which means
requests for information
about you
may be
denied unless
we have
your written
permission to
release the
information to
the requester
or unless
the information is
subject to
disclosure under
the Freedom
of Information
Act. The
Agreements and
Certifications section
of this
form contains
written permission
for us
to disclose
the information
resulting from
this collection
to state,
local or
private disaster
relief services.
The Privacy Act authorizes SBA to make certain "routine uses"
of information protected by that Act. One such routine use for SBA's
loan system of records is that
when this information indicates a violation or potential violation
of law, whether civil, criminal, or
administrative in
nature, SBA
may refer
it to
the appropriate
agency, whether
Federal, State,
local or
foreign, charged
with responsibility
for or otherwise involved in investigation, prosecution, enforcement
or prevention of such violations. Another routine use of personal
information is to assist in obtaining credit bureau reports, on the
Disaster Loan Applicants and guarantors for purposes of originating,
servicing, and liquidating Disaster loans. See, 69 F.R. 58598, 58616
(and as amended from time to time) for additional background and
other routine uses.
Under the provisions of the Privacy Act, you are not required to
provide social security numbers. (But see the information under Debt
Collection Act below). In addition to the reasons described below,
we use social security numbers to distinguish between people with
a similar
or the
same name
for credit
decisions and
for debt
collection purposes.
Failure to
provide this
number may
not affect
any right, benefit or privilege to which you are entitled by
law, but having the number makes it easier for us to more accurately
identify to whom adverse credit information applies and to keep
accurate loan records.
Note: Any
person concerned
with the
collection, use
and disclosure
of information,
under the
Privacy Act
may contact
the Chief,
FOI/ PA Office,
409 3rd Street, SW, Suite 5900, Washington, DC 20416 or by e-mail at
[email protected]
for information about the Agency's
procedures relating to the Privacy Act and the Freedom of
Information
Act.
DEBT COLLECTION ACT OF 1982
(5 U.S.C. 5514 note); DEBT COLLECTION IMPROVEMENT ACT OF 1996, as amended
(31 U.S.C. 3701 et seq.)
These laws require us to aggressively collect any delinquent loan
payments and/or to require you to give your taxpayer identification
number to us when you apply for a loan (31 U.S.C. 7701). If you
receive a loan and do not make payments when they become due, we may
take one or more of the following actions (this list may not be
exhaustive):
*Report the delinquency to credit reporting bureaus. *Offset
your income tax refunds or other amounts due to you from the Federal
Government. *Refer
the account to a private collection agency or other agency operating
a debt collection center. *Suspend
or debar you from doing business with the Federal Government. *Refer
your loan to the Department of Justice. *Foreclose
on collateral or take other actions permitted in the loan
instruments. *Garnish
wages. *Sell
the debt. *Litigate
or foreclose.
SBA
Form 5 (XX-XX) Ref SOP 50 30
Page 2 of 3
RIGHT TO FINANCIAL PRIVACY ACT
OF 1978 (12 U.S.C. 3401 et seq.)
This notifies
you, as
required by
the Right
to Financial
Privacy Act
of 1978
(Act), of
our right
to access
financial records
held by
financial institutions
that were or are doing business with you or your business. This
includes financial institutions participating in loans or loan
guarantees.
The law provides that we may access your financial records when
considering or administering Government loan or loan guaranty
assistance to
you. We must give a financial institution a certificate of our
compliance with the Act when we first request access to your
financial records. No other certification is required for later
access. Our access rights continue for the term of any approved loan
or loan guaranty. We do not have to give you any additional notice
of our access rights during the term of the loan or loan guaranty.
We may transfer to another Government authority any financial
records included in a loan application or about an approved loan or
loan
guaranty as necessary to process, service, liquidate, or foreclose a
loan or loan guaranty. We will not permit any transfer of your
financial records to another Government authority except as required
or permitted by law.
Paperwork Reduction Act (44 U.S.C. Chapter 35)
We are collecting the information on this form in order to make
disaster loans available to qualified small businesses. The form is designed to collect the
information necessary for us to make eligibility and credit
decisions in order to fund or deny loan requests. We will also use
the information collected on this form to produce summary reports
for program and management analysis, as required by law.
PLEASE NOTE: The estimated burden for completing this form is 1.25
hours. Your responses to the requested information are required in
order to obtain a benefit under SBA's Disaster Business Loan
Programs. However, you are not required to respond to any
collection of information unless it displays a currently valid OMB
approval number. If you
have any questions or comments concerning any aspects of this
information collection, please contact the U.S. Small Business
Administration Information Branch, 409 3rd
St., SW, Washington, DC 20416 and Desk Officer for
SBA, Office of Management and Budget, Office of Information and
Regulatory Affairs, 725
17th St.,
NW, Washington, DC 20503. (3245-0017) PLEASE DO NOT
SEND FORMS TO OMB.
Policy Concerning Representatives and Their Fees
When you apply for an SBA loan, you may use an attorney, accountant,
engineer, appraiser or other representative to help
prepare and present the application to us. You are not required to
have representation. If an application is approved, you may need an
attorney to help prepare closing documents.
There are no "authorized representatives" of SBA, other
than our regular salaried employees. Payment of a fee or gratuity to
our employees
is illegal and will subject those involved to prosecution.
SBA regulations prohibit representatives from proposing or charging
any fee for services performed in connection with your loan unless we consider
the services necessary and the amount reasonable. The regulations
also prohibit charging you any commitment, bonus, broker,
commission, referral or similar fee. We will not approve the payment
of any bonus, brokerage fee or commission. Also, we will not approve
placement or finder's fees for using or trying to use influence in
the SBA loan application
process.
Fees to representatives must be reasonable for services provided in
connection with the application or the closing and based upon the
time and effort required, the qualifications of the representative,
and the nature and extent of work performed. Representatives must
execute a compensation agreement.
In the appropriate section of the application, you must state the
names of everyone employed by you or on your behalf. You
must also notify the SBA disaster office in writing of the names and
fees of any representative you employ after you file your
application.
If you have any questions concerning payment of fees or
reasonableness of fees, contact the Disaster Field Office where you
filed or will file your application or call the SBA Customer Service
Center at 1-800-659-2955.
Occupational Safety and Health Act (29 U.S.C. 3651 et seq.)
This legislation authorizes the Occupational Safety and Health
Administration (OSHA) in the Department of Labor to require businesses
to modify
facilities and
procedures to
protect employees
when appropriate.
If your
business does
not do
so, you
may be penalized, forced to close or prevented from starting
operations in a new facility. Because of this, we may require
information from you to determine whether your business complies
with OSHA regulations and may continue operating after the loan is
approved or disbursed. You must certify to us that OSHA requirements
applying to your business have been determined and that you are, to
the best of your knowledge, in
compliance.
SBA
Form 5 (XX-XX) Ref SOP 50 30
Page 3 of 3
File Type | text/rtf |
File Title | SBA Business Loan Application |
Subject | Business Loan Application |
Author | Pitts, Cynthia G. |
Last Modified By | Rich, Curtis B. |
File Modified | 2021-08-27 |
File Created | 2021-08-27 |