OMB Approval No.: 3245-0200
Expiration Date: 04/30/2022
SBA FORM 1050, SETTLEMENT SHEET
Purpose: The purpose of this form is to document and verify that loan proceeds have been disbursed in
accordance with the Authorization and to document that the Borrower’s contribution has been injected into
the business prior to the Lender disbursing any loan proceeds.
General Instructions: This form may be used for all 7(a) loans and for all disbursements. It must be used for the
first disbursement on all standard 7(a) loans over $350,000.
This form is to be completed by the Lender and signed by the Lender and the Borrower at the time of the initial
loan disbursement. The Lender must retain a copy of the signed form in its loan file. For all disbursements, the
Lender must also retain documentation that is acceptable to SBA (such as joint payee checks, cancelled
checks, paid receipts or invoices, wire transfer account records, etc.) and that evidences compliance with the
Use of Proceeds section of the Authorization.
The Lender must submit the completed form and all supporting documentation to SBA upon request, or, in the
event of a loan default, with the Lender’s request for guaranty purchase.
Providing this information is required to comply with program requirements; failure to provide it when
required may impair the Lender’s ability to collect on the SBA loan guaranty.
If additional space is required to complete the form or provide additional details please attach a separate
sheet.
Specific Instructions for Completing the Form:
1) In the first section, fill in all identifying information. For “Loan Type,” check the box to indicate whether
the loan is a term loan or a revolving line of credit.
2) Complete the “Use of Proceeds” section with information related to the initial disbursement.
a) On the line associated with each applicable use of proceeds, indicate:
i) The name of the payee (must identify the ultimate recipient, not an intermediary such as a title
company);
ii) Amount disbursed; and
iii) Remaining amount to be disbursed, in accordance with theAuthorization.
b) For the “Settlement charges/out of pocket costs” line, insert total amount of settlement charges and
other out of pocket costs in the appropriate field within the grid. Attach an itemized list of all charges
and costs, including the name of payee and amount paid for each charge or cost. Reminder: SBA
Form 159 is required for all fees paid or to be paid by the Lender (except Lender Service Provider fees)
and for all fees paid or to be paid by the Applicant to any agent in connection with the SBA loan
application.)
c) For “Other (Explain),” enter any other use of proceeds authorized in the Authorization that is not
already listed in the grid, if applicable.
3) Complete the “Borrower’s Injection” section.
a) For each type of injection, indicate the source.
b) If the Seller contributed toward required equity, attach a copy of the Note and evidence of
full standby for the life of the loan.
c) Note: The Borrower’s Injection must be in the business bank account prior to any
disbursement of loan proceeds.
4) The Lender and the Borrower must review the certification and execute the form in the space provided.
SBA Form 1050 (04-19) Previous Editions Obsolete Page 1 of 2
