Fillable BSC PPP Loan Application

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SBA 7
(a) Payment Protection Program
(PPP) Application
SBA 7(a) Paycheck Protection
Program (PPP) Application
o Business entity documentation
o If available, provide Federal payroll tax return for 2019; and for the period of
January 1, 2020 to present. If this is not available, please provide Form 941,
the Employer’s Quarterly Tax Return.
o If available, provide State payroll tax return and unemployment insurance
filings for 2019; and for the period of January 1, 2020 to present.
Please know that this is a preliminary application and the SBA may require additional
information to meet their criteria for this program. We will contact you if additional
information is needed.
Please contact me directly with any questions.
Bank of Southern California is committed to helping small businesses affected by the
Coronavirus. As an SBA Preferred Lender, we can help your business obtain funding
through the SBA's Payment Protection Program (PPP).
We understand the urgency of your financial need, so while we are awaiting the SBA's
streamlined underwriting and loan documentation process we have created the following
preliminary application package that will allow us to add your request to our processing
queue. Funding of this program is limited so know that we are committed to handling your
request with priority once we receive SBA's guidance.
Please forward the following additional information stated below along with the fully
completed application.
Contact Name
Business Name
Banker
Banker Email
Banker Phone Number
Paycheck Protection Program
Borrower Application Form
1
SBA Form 2483 (04/20)
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Check One: Sole proprietor Partnership C-Corp S-Corp LLC
Independent contractor Eligible self-employed individual
501(c)(3) nonprofit 501(c)(19) veterans organization
Tribal business (sec. 31(b)(2)(C) of Small Business Act) Other
DBA or Tradename if Applicable
Business Le
g
al Name
Business Address Business TIN (EIN, SSN) Business Phone
( ) -
Primary Contact Email Address
Average Monthly Payroll: $ x 2.5 + EIDL, Net of
Advance (if Applicable)
E
q
uals Loan Re
q
uest:
$
Number of Employees:
Purpose of the loan
(select more than one):
☐Payroll ☐Lease / Mortgage Interest ☐Utilities ☐Other (explain):__________________
Applicant Ownership
List all owners of 20% or more of the equity of the Applicant. Attach a separate sheet if necessary.
Owner Name Title Ownership % TIN (EIN, SSN) Address
If questions (1) or (2) below are answered “Yes,” the loan will not be approved.
Question Yes No
1. Is the Applicant or any owner of the Applicant presently suspended, debarred, proposed for debarment, declared ineligible,
voluntarily excluded from participation in this transaction by any Federal department or agency, or presently involved in any
bankruptcy?
2. Has the Applicant, any owner of the Applicant, or any business owned or controlled by any of them, ever obtained a direct or
guaranteed loan from SBA or any other Federal agency that is currently delinquent or has defaulted in the last 7 years and
caused a loss to the government?
3. Is the Applicant or any owner of the Applicant an owner of any other business, or have common management with, any other
business? If yes, list all such businesses and describe the relationship on a separate sheet identified as addendum A.
4. Has the Applicant received an SBA Economic Injury Disaster Loan between January 31, 2020 and April 3, 2020? If yes,
provide details on a separate sheet identified as addendum B.
If questions (5) or (6) are answered “Yes,” the loan will not be approved.
Question
Yes No
5. Is the Applicant (if an individual) or any individual owning 20% or more of the equity of the Applicant subject
to an indictment, criminal information, arraignment, or other means by which formal criminal charges are
brought in any jurisdiction, or presently incarcerated, or on probation or parole?
Initial here to confirm your response to question 5 →
6. Within the last 5
years, for any felony, has the Applicant (if an individual) or any owner of the Applicant 1)
been convicted; 2) pleaded guilty; 3) pleaded nolo contendere; 4) been placed on pretrial diversion; or 5) been
placed on any form of parole or probation (including probation before judgment)?
Initial here to confirm your response to question 6 →
7. Is the United States the principal place of residence for all employees of the Applicant included in the
Applicant’s payroll calculation above?
8. Is the Applicant a franc
hise that is listed in the SBA’s Franchise Directory?
OMB Control No.: 3245-0407
Expiration Date: 09/30/2020
Paycheck Protection Program
Borrower Application Form
2
SBA Form 2483 (04/20)
By Signing Below, You Make the Following Representations, Authorizations, and Certifications
CERTIFICATIONS AND AUTHORIZATIONS
I certify that:
I have read the statements included in this form, including the Statements Required by Law and Executive Orders, and I understand them.
The Applicant is eligible to receive a loan under the rules in effect at the time this application is submitted that have been issued by the
Small Business Administration (SBA) implementing the Paycheck Protection Program under Division A, Title I of the Coronavirus
Aid, Relief, and Economic Security Act (CARES Act) (the Paycheck Protection Program Rule).
The Applicant (1) is an independent contractor, eligible self-employed individual, or sole proprietor or (2) employs no more
than the greater of 500 or employees or, if applicable, the size standard in number of employees established by the SBA in 13
C.F.R. 121.201 for the Applicant’s industry.
I will comply, whenever applicable, with the civil rights and other limitations in this form.
All SBA loan proceeds will be used only for business-related purposes as specified in the loan application and consistent with the
Paycheck Protection Program Rule.
To the extent feasible, I will purchase only American-made equipment and products.
The Applicant is not engaged in any activity that is illegal under federal, state or local law.
Any loan received by the Applicant under Section 7(b)(2) of the Small Business Act between January 31, 2020 and April 3, 2020 was
for a purpose other than paying payroll costs and other allowable uses loans under the Paycheck Protection Program Rule.
For Applicants who are individuals: I authorize the SBA to request criminal record information about me from criminal justice agencies for the
purpose of determining my eligibility for programs authorized by the Small Business Act, as amended.
CERTIFICATIONS
The authorized representative of the Applicant must certify in good faith to all of the below by initialing next to each one:
_____ The Applicant was in operation on February 15, 2020 and had employees for whom it paid salaries and payroll taxes or paid independent
contractors, as reported on Form(s) 1099-MISC.
_____ Current economic uncertainty makes this loan request necessary to support the ongoing operations of the Applicant.
_____ The funds will be used to retain workers and maintain payroll or make mortgage interest payments, lease payments, and utility payments,
as specified under the Paycheck Protection Program Rule; I understand that if the funds are knowingly used for unauthorized purposes,
the federal government may hold me legally liable, such as for charges of fraud.
_____ The Applicant will provide to the Lender documentation verifying the number of full-time equivalent employees on the Applicant’s
payroll as well as the dollar amounts of payroll costs, covered mortgage interest payments, covered rent payments, and covered utilities
for the eight-week period following this loan.
_____ I understand that loan forgiveness will be provided for the sum of documented payroll costs, covered mortgage interest payments,
covered rent payments, and covered utilities, and not more than 25% of the forgiven amount may be for non-payroll costs.
_____ During the period beginning on February 15, 2020 and ending on December 31, 2020, the Applicant has not and will not receive another
loan under the Paycheck Protection Program.
_____ I further certify that the information provided in this application and the information provided in all supporting documents and
forms is true and accurate in all material respects. I understand that knowingly making a false statement to obtain a guaranteed loan
from SBA is punishable under the law, including under
18 USC 1001 and 3571 by imprisonment of not more than five years and/or a
fine of up to $250,000; under 15 USC 645 by imprisonment of not more than two years and/or a fine of not more than $5,000; and, if
submitted to a federally insured institution, under 18 USC 1014 by imprisonment of not more than thirty years and/or a fine of not
more than $1,000,000.
_____
I acknowledge that the lender will confirm the eligible loan amount using required documents submitted. I understand,
acknowledge and agree that the Lender can share any tax information that I have provided with SBA's authorized representatives,
including authorized representatives of the SBA Office of Inspector General, for the purpose of compliance with SBA Loan
Program Requirements and all SBA reviews.
_________________________________________________________ ________________________
Signature of Authorized Representative of Applicant Date
Print Name Title
click to sign
signature
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Paycheck Protection Program
Borrower Application Form
3
SBA Form 2483 (04/20)
Purpose of this form:
This form is to be completed by the authorized representative of the Applicant and submitted to your SBA Participating Lender. Submission of
the requested information is required to make a determination regarding eligibility for financial assistance. Failure to submit the information
would affect that determination.
Instructions for completing this form:
With respect to “purpose of the loan,” payroll costs consist of compensation to employees (whose principal place of residence is the United
States) in the form of salary, wages, commissions, or similar compensation; cash tips or the equivalent (based on employer records of past tips
or, in the absence of such records, a reasonable, good-faith employer estimate of such tips); payment for vacation, parental, family, medical, or
sick leave; allowance for separation or dismissal; payment for the provision of employee benefits consisting of group health care coverage,
including insurance premiums, and retirement; payment of state and local taxes assessed on compensation of employees; and for an
independent contractor or sole proprietor, wage, commissions, income, or net earnings from self-employment or similar compensation.
For purposes of calculating “Average Monthly Payroll,” most Applicants will use the average monthly payroll for 2019, excluding costs over
$100,000 on an annualized basis for each employee. For seasonal businesses, the Applicant may elect to instead use average monthly payroll
for the time period between February 15, 2019 and June 30, 2019, excluding costs over $100,000 on an annualized basis for each employee.
For new businesses, average monthly payroll may be calculated using the time period from January 1, 2020 to February 29, 2020, excluding
costs over $100,000 on an annualized basis for each employee.
If Applicant is refinancing an Economic Injury Disaster Loan (EIDL): Add the outstanding amount of an EIDL made between January 31, 2020
and April 3, 2020, less the amount of any “advance” under an EIDL COVID-19 loan, to Loan Request as indicated on the form.
All parties listed below are considered owners of the Applicant as defined in 13 CFR § 120.10, as well as “principals”:
For a sole proprietorship, the sole proprietor;
For a partnership, all general partners, and all limited partners owning 20% or more of the equity of the firm;
For a corporation, all owners of 20% or more of the corporation;
For limited liability companies, all members owning 20% or more of the company; and
Any Trustor (if the Applicant is owned by a trust).
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 time for completing this application, including gathering data needed, is 8 minutes. Comments about this time
or the information requested should be sent to : Small Business Administration, Director, Records Management Division, 409 3rd St., SW,
Washington DC 20416., and/or SBA Desk Officer, Office of Management and Budget, New Executive Office Building, Washington DC
20503.
Privacy Act (5 U.S.C. 552a) – Under the provisions of the Privacy Act, you are not required to provide your social security number. Failure to
provide your social security number may not affect any right, benefit or privilege to which you are entitled. (But see Debt Collection Notice
regarding taxpayer identification number below.) Disclosures of name and other personal identifiers are required to provide SBA with
sufficient information to make a character determination. When evaluating character, SBA considers the person’s integrity, candor, and
disposition toward criminal actions. Additionally, SBA is specifically authorized to verify your criminal history, or lack thereof, pursuant to
section 7(a)(1)(B), 15 USC Section 636(a)(1)(B) of the Small Business Act (the Act).
Disclosure of Information – Requests for information about another party may be denied unless SBA has the written permission of the
individual to release the information to the requestor or unless the information is subject to disclosure under the Freedom of Information Act.
The Privacy Act authorizes SBA to make certain “routine uses” of information protected by that Act. One such routine use is the disclosure of
information maintained in SBA’s system of records when this information indicates a violation or potential violation of law, whether civil,
criminal, or administrative in nature. Specifically, SBA may refer the information 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 is disclosure to other Federal agencies conducting background checks but only to the extent the information is relevant to
the requesting agencies' function. See, 74 F.R. 14890 (2009), and as amended from time to time for additional background and other routine
uses. In addition, the CARES Act, requires SBA to register every loan made under the Paycheck Protection Act using the Taxpayer
Identification Number (TIN) assigned to the borrower.
Debt Collection Act of 1982, Deficit Reduction Act of 1984 (31 U.S.C. 3701 et seq. and other titles) – SBA must obtain your taxpayer
identification number when you apply for a loan. If you receive a loan, and do not make payments as they come due, SBA may: (1) report the
status of your loan(s) to credit bureaus, (2) hire a collection agency to collect your loan, (3) offset your income tax refund or other amounts
due to you from the Federal Government, (4) suspend or debar you or your company from doing business with the Federal Government, (5)
refer your loan to the Department of Justice, or (6) foreclose on collateral or take other action permitted in the loan instruments.
Right to Financial Privacy Act of 1978 (12 U.S.C. 3401) – The Right to Financial Privacy Act of 1978, grants SBA access rights to
financial records held by financial institutions that are or have been doing business with you or your business including any financial
Paycheck Protection Program
Borrower Application Form
4
SBA Form 2483 (04/20)
institutions participating in a loan or loan guaranty. SBA is only required provide a certificate of its compliance with the Act to a financial
institution in connection with its first request for access to your financial records. SBA's access rights continue for the term of any approved
loan guaranty agreement. SBA is also authorized to transfer to another Government authority any financial records concerning an approved
loan or loan guarantee, as necessary to process, service or foreclose on a loan guaranty or collect on a defaulted loan guaranty.
Freedom of Information Act (5 U.S.C. 552) – Subject to certain exceptions, SBA must supply information reflected in agency files and
records to a person requesting it. Information about approved loans that will be automatically released includes, among other things, statistics
on our loan programs (individual borrowers are not identified in the statistics) and other information such as the names of the borrowers (and
their officers, directors, stockholders or partners), the collateral pledged to secure the loan, the amount of the loan, its purpose in general terms
and the maturity. Proprietary data on a borrower would not routinely be made available to third parties. All requests under this Act are to be
addressed to the nearest SBA office and be identified as a Freedom of Information request.
Occupational Safety and Health Act (15 U.S.C. 651 et seq.) – The Occupational Safety and Health Administration (OSHA) can require
businesses to modify facilities and procedures to protect employees. Businesses that do not comply may be fined, forced to cease operations,
or prevented from starting operations. Signing this form is certification that the applicant, to the best of its knowledge, is in compliance with
the applicable OSHA requirements, and will remain in compliance during the life of the loan.
Civil Rights (13 C.F.R. 112, 113, 117) – All businesses receiving SBA financial assistance must agree not to discriminate in any business
practice, including employment practices and services to the public on the basis of categories cited in 13 C.F.R., Parts 112, 113, and 117 of
SBA Regulations. All borrowers must display the "Equal Employment Opportunity Poster" prescribed by SBA.
Equal Credit Opportunity Act (15 U.S.C. 1691) – Creditors are prohibited from discriminating against credit applicants on the basis of race,
color, religion, national origin, sex, marital status or age (provided the applicant has the capacity to enter into a binding contract); because all
or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right
under the Consumer Credit Protection Act.
Debarment and Suspension Executive Order 12549; (2 CFR Part 180 and Part 2700) – By submitting this loan application, you certify
that neither the Applicant or any owner of the Applicant have within the past three years been: (a) debarred, suspended, declared ineligible or
voluntarily excluded from participation in a transaction by any Federal Agency; (b) formally proposed for debarment, with a final
determination still pending; (c) indicted, convicted, or had a civil judgment rendered against you for any of the offenses listed in the
regulations or (d) delinquent on any amounts owed to the U.S. Government or its instrumentalities as of the date of execution of this
certification.
The Paycheck Protection Program (“PPP”) authorizes up to $349 billion in forgivable loans to
small businesses to pay their employees during the COVID-19 crisis. All loan terms will be the
same for everyone.
The loan amounts will be forgiven as long as:
• The loan proceeds are used to cover payroll costs, and most mortgage interest, rent, and
utility costs over the 8 week period after the loan is made; and
• Employee and compensation levels are maintained.
Payroll costs are capped at $100,000 on an annualized basis for each employee. Due to likely
high subscription, it is anticipated that not more than 25% of the forgiven amount may be for
non-payroll costs.
Loan payments will be deferred for 6 months.
When can I apply?
• Starting April 3, 2020, small businesses and sole proprietorships can apply for and
receive loans to cover their payroll and other certain expenses through existing SBA
lenders.
• Starting April 10, 2020, independent contractors and self-employed individuals can
apply for and receive loans to cover their payroll and other certain expenses through
existing SBA lenders.
• Other regulated lenders will be available to make these loans as soon as they are
approved and enrolled in the program.
Where can I apply? You can apply through any existing SBA lender or through any federally
insured depository institution, federally insured credit union, and Farm Credit System institution
that is participating. Other regulated lenders will be available to make these loans once they are
approved and enrolled in the program. You should consult with your local lender as to whether it
is participating. Visit www.sba.gov for a list of SBA lenders.
Who can apply? All businesses – including nonprofits, veterans organizations, Tribal business
concerns, sole proprietorships, self-employed individuals, and independent contractors – with 500
or fewer employees can apply. Businesses in certain industries can have more than 500
employees if they meet applicable SBA employee-based size standards for those industries (click
HERE for additional detail).
For this program, the SBA’s affiliation standards are waived for small businesses (1) in the hotel
and food services industries (click HERE for NAICS code 72 to confirm); or (2) that are franchises
in the SBA’s Franchise Directory (click HERE to check); or (3) that receive financial assistance from
small business investment companies licensed by the SBA. Additional guidance may be released as
appropriate.
PAYCHECK PROTECTION PROGRAM (PPP)
INFORMATION SHEET: BORROWERS
What do I need to apply? You will need to complete the Paycheck Protection Program loan
application and submit the application with the required documentation to an approved lender
that is available to process your application by June 30, 2020. Click HERE for the application.
What other documents will I need to include in my application? You will need to provide your
lender with payroll documentation.
Do I need to first look for other funds before applying to this program? No. We are waiving the
usual SBA requirement that you try to obtain some or all of the loan funds from other sources (i.e.,
we are waiving the Credit Elsewhere requirement).
How long will this program last? Although the program is open until June 30, 2020, we encourage
you to apply as quickly as you can because there is a funding cap and lenders need time to
process your loan.
How many loans can I take out under this program? Only one.
What can I use these loans for? You should use the proceeds from these loans on your:
• Payroll costs, including benefits;
• Interest on mortgage obligations, incurred before February 15, 2020;
• Rent, under lease agreements in force before February 15, 2020; and
• Utilities, for which service began before February 15, 2020.
What counts as payroll costs? Payroll costs include:
• Salary, wages, commissions, or tips (capped at $100,000 on an annualized basis for each
employee);
• Employee benefits including costs for vacation, parental, family, medical, or sick leave;
allowance for separation or dismissal; payments required for the provisions of group
health care benefits including insurance premiums; and payment of any retirement benefit;
• State and local taxes assessed on compensation; and
• For a sole proprietor or independent contractor: wages, commissions, income, or net
earnings from self-employment, capped at $100,000 on an annualized basis for each
employee.
How large can my loan be? Loans can be for up to two months of your average monthly payroll
costs from the last year plus an additional 25% of that amount. That amount is subject to a $10
million cap. If you are a seasonal or new business, you will use different applicable time periods
for your calculation. Payroll costs will be capped at $100,000 annualized for each employee.
How much of my loan will be forgiven? You will owe money when your loan is due if you use the
loan amount for anything other than payroll costs, mortgage interest, rent, and utilities payments
over the 8 weeks after getting the loan. Due to likely high subscription, it is anticipated that not
more than 25% of the forgiven amount may be for non-payroll costs.
You will also owe money if you do not maintain your staff and payroll.
• Number of Staff: Your loan forgiveness will be reduced if you decrease your full-time
employee headcount.
• Level of Payroll: Your loan forgiveness will also be reduced if you decrease salaries and
wages by more than 25% for any employee that made less than $100,000 annualized in
2019.
• Re-Hiring: You have until June 30, 2020 to restore your full-time employment and salary
levels for any changes made between February 15, 2020 and April 26, 2020.
How can I request loan forgiveness? You can submit a request to the lender that is servicing the
loan. The request will include documents that verify the number of full-time equivalent
employees and pay rates, as well as the payments on eligible mortgage, lease, and utility
obligations. You must certify that the documents are true and that you used the forgiveness
amount to keep employees and make eligible mortgage interest, rent, and utility payments. The
lender must make a decision on the forgiveness within 60 days.
What is my interest rate? 1.00% fixed rate.
When do I need to start paying interest on my loan? All payments are deferred for 6 months;
however, interest will continue to accrue over this period.
When is my loan due? In 2 years.
Can I pay my loan earlier than 2 years? Yes. There are no prepayment penalties or fees.
Do I need to pledge any collateral for these loans? No. No collateral is required.
Do I need to personally guarantee this loan? No. There is no personal guarantee requirement.
***However, if the proceeds are used for fraudulent purposes, the U.S. government will pursue
criminal charges against you.***
What do I need to certify? As part of your application, you need to certify in good faith that:
• Current economic uncertainty makes the loan necessary to support your ongoing
operations.
• The funds will be used to retain workers and maintain payroll or to make mortgage, lease,
and utility payments.
• You have not and will not receive another loan under this program.
• You will provide to the lender documentation that verifies the number of full-time
equivalent employees on payroll and the dollar amounts of payroll costs, covered
mortgage interest payments, covered rent payments, and covered utilities for the eight
weeks after getting this loan.
• Loan forgiveness will be provided for the sum of documented payroll costs, covered
mortgage interest payments, covered rent payments, and covered utilities. Due to likely
high subscription, it is anticipated that not more than 25% of the forgiven amount may be
for non-payroll costs.
• All the information you provided in your application and in all supporting documents and
forms is true and accurate. Knowingly making a false statement to get a loan under this
program is punishable by law.
• You acknowledge that the lender will calculate the eligible loan amount using the tax
documents you submitted. You affirm that the tax documents are identical to those you
submitted to the IRS. And you also understand, acknowledge, and agree that the lender
can share the tax information with the SBA’s authorized representatives, including
authorized representatives of the SBA Office of Inspector General, for the purpose of
compliance with SBA Loan Program Requirements and all SBA reviews.
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BSC PPP Loan Application

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