SBA Form 34 Bank ID

OMB Approval No. 3245-0081

Expiration Date XX-XX-XXXX

Office of Investment and Innovation
Small Business Administration

Instructions for Bank Identification Form (SBA Form 34)
(Funding Net Proceeds)

The U.S. Small Business Administration (“SBA”) has made arrangements to have the proceeds of SBA-guaranteed leverage disbursed to SBICs by wire transfer of funds to the bank accounts of the SBICs. This procedure will minimize the time lag between receipt of such proceeds and the availability of the net proceeds to the SBICs.

An SBIC’s account may be with a bank that participates in the Fedwire Funds Service (“PARTICIPANT BANK”). If an SBIC’s account is with a PARTICIPANT BANK, the SBA or its agent will wire the net proceeds of the funding directly to the SBIC’s bank for credit to the SBIC's bank account.

If the SBIC's account is not with a PARTICIPANT BANK, the non-PARTICIPANT bank or other financial institution where the funds are to be deposited must have the necessary agreements in place authorizing the PARTICIPANT BANK to act on its behalf. In this case, the SBA or its agent will wire the net proceeds of the funding to the PARTICIPANT BANK, which will then credit the SBIC’s bank or financial institution for further credit to the SBIC’s account.

In order to receive funds (as described above), each SBIC must furnish the requested information and have an authorized official sign and date the attached form. Please answer the question on the attached form and provide the required information.

A new Bank Identification Form must be submitted to SBA if an SBIC’s bank information changes. Please submit a new form by e-mail to: [email protected]. SBA encourages the use of secure e-mail or encryption to safeguard such information during transmission.

NOTE: Failure to provide any part of this information, or the filing of inaccurate information may delay the SBIC’s receipt of funds or prevent SBA or its agents from including the SBIC’s leverage request in the funding of net proceeds.

PLEASE NOTE: The estimated burden for completing this form is 20 minutes 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 U.S. Small Business Administration, Chief, AIB, 409 Third Street., SW, Washington D.C. 20416 and Desk Officer for the Small Business Administration, Office of Management and Budget, New Executive Office Building, Room 10202, Washington, D.C. 20503. OMB Approval (3245-0081).

DO NOT SEND FORMS TO OMB.

SBA Form 34 (Revised XX-XX) (Instructions)

BANK IDENTIFICATION FORM
for
DISBURSEMENT OF LICENSEE'S AMOUNT OF NET PROCEEDS

ANSWER THE FOLLOWING QUESTION AND READ THE INSTRUCTIONS BEFORE COMPLETING THE INFORMATION REQUIRED BELOW.

Is the SBIC’s account with a bank that is a PARTICIPANT OF THE FEDWIRE FUNDS SERVICE (PARTICIPANT BANK)? (Check one) [ ] YES [ ] NO

If the answer to the above question is YES, complete only Section I below.

If the answer to the above question is NO, complete both Sections I & II below.

SBIC BANK IDENTIFICATION INFORMATION

Section I --PARTICIPANT BANK (AGENT BANK)

Account Number: _______________________________________________________

ABA Number: __________________________________________________________

Name of Bank: _________________________________________________________

Street Address: _________________________________________________________

City: ______________________________ State: __________ Zip: ___________

Section II – NON-PARTICIPANT MEMBER (BANK OR OTHER FINANCIAL INSTITUTION):

Account Number: _______________________________________________________

ID Number (Routing (ABA) Number,
Bank Identifier Code (BIC), UID, or Other ID): _______________________________

Name of Bank or Other
Financial Institution: ____________________________________________________

Additional Information (if needed): _________________________________________

Street Address: _________________________________________________________

City: ______________________________ State: __________ Zip: ___________

By: ___________________________________ ___________________
(Name of SBIC or Applicant) (License No., if issued)

___________________________________ ___________________
(Authorized Signature) (Date)

SBA Form 34 (Revised XX-XX)