Paycheck Protection Program
Borrower Application Form for Schedule C Filers Using Gross Income
March 3, 2021
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
An Applicant that files an IRS Form 1040, Schedule C, and elects to calculate the PPP loan amount using gross income must use this form. An Applicant
that files an IRS Form 1040, Schedule C, and elects to calculate the PPP loan amount using net profit must use SBA Form 2483. An Applicant that files an
IRS Form 1040, Schedule F, and calculates the PPP loan amount using gross income must use SBA Form 2483.
Instructions for completing this form:
For purposes of reporting Year of Establishment, applicants may enter “NA”.
For purposes of reporting NAICS Code, applicants must match the business activity code provided on their IRS income tax filings, if applicable.
For purposes of reporting Number of Employees, sole proprietors, self-employed individuals, and independent contractors should include themselves as
employees (i.e., the minimum number in the box Number of Employees is one). Applicants may use their average employment over the time period used to
calculate their aggregate payroll costs to determine their number of employees. Alternatively, Applicants may elect to use the average number of employees
per pay period in the 12 completed calendar months prior to the date of the loan application.
For purposes of calculating Average Monthly Payroll for Employees (box C), Applicants must use the average monthly payroll for 2019 or 2020 for
employees (not including the owner), excluding costs over $100,000 on an annualized basis, as prorated for the period during which the payments are made
or the obligation to make the payments is incurred, for each employee. The payroll year used must be the same as the tax year used for the gross income
calculation (box A in either table). For seasonal businesses, the Applicant may elect to instead use average total monthly payroll for any twelve-week period
selected by the Applicant between February 15, 2019 and February 15, 2020, excluding costs over $100,000 on an annualized basis, as prorated for the
period during which the payments are made or the obligation to make the payments is incurred, 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, as
prorated for the period during which the payments are made or the obligation to make the payments is incurred, 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 to Loan Request as indicated on the form. Do not add the amount of any EIDL Advance.
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 (except those paid leave
amounts for which a credit is allowed under FFCRA Sections 7001 and 7003); allowance for separation or dismissal; payment for the provision of employee
benefits (including insurance premiums) consisting of group health care coverage, group life, disability, vision, or dental insurance, and retirement benefits;
payment of state and local taxes assessed on compensation of employees; and wages, commissions, income, or net earnings from self-employment or similar
compensation. This includes proprietor expenses, which means businesses expenses plus owner compensation.
If the Applicant is a qualified joint venture for federal income tax purposes ((1) the only members of the joint venture are a married couple who file a joint
return and each file Schedule C, (2) both spouses materially participate in the trade or business, and (3) both spouses elect not to be treated as a partnership),
only one spouse may submit this form on behalf of the qualified joint venture. For purposes of reporting Number of Employees, each spouse should be
counted. For purposes of determining which table to use to calculate Loan Request Amount, if the Applicant has no employees other than the married couple,
complete the table labeled “If you do not have any employees other than yourself, complete this table.” For purposes of calculating gross income, enter the
sum of gross income (Schedule C, line 7) from both spouses. For purposes of calculating the Loan Request Amount, the amount entered in box B in either
table is capped at $8,333.33.
For a sole proprietorship, the sole proprietor is considered the owner of the Applicant. For a limited liability company that has only one member and that is
treated as a disregarded entity for federal income tax purposes and files Schedule C, the member is considered a sole proprietor and the owner of the
Applicant. If the Applicant is treated as a qualified joint venture for federal income tax purposes (the only members of the joint venture are a married couple
who file a joint return and each file a Schedule C), both spouses are considered sole proprietors and owners of the Applicant.
For purposes of reporting (optional) demographic information:
1. Purpose. Veteran/gender/race/ethnicity data is collected for program reporting purposes only.
2. Description. This form requests information about each of the Applicant’s Principals. Add additional sheets if necessary.
3. Definition of Principal. The term “Principal” means:
• The self-employed individual, independent contractor, or sole proprietor.
• Any individual hired by the Applicant to manage the day-to-day operations of the Applicant (“key employee”).
4. Principal Name. Insert the full name of the Principal.
5. Principal Position. Identify the Principal’s position: self-employed individual, independent contractor, sole proprietor, or key employee.
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. PLEASE DO NOT SEND FORMS TO THESE