SBA Form 1919 (Revised 09/20)
11
SBA 7(a) Borrower Information Form
Statements Required by Law and Executive Order
OMB Control No.: 3245-0348
Expiration Date: 09/30/2023
Please read the following notices regarding use of federal financial assistance programs and then sign
and date the certification.
This application and any assistance provided pursuant to this application is subject to the following laws, regulations,
and Executive Orders.
Privacy Act (5 U.S.C. 552a); Collection of Social Security Number (31 U.S.C.7701)
Authorities and Purpose for Collecting Information: SBA is collecting the information on this form, including social
security numbers and other personal information, to make a character and credit eligibility decision in connection with
you or your company's application for SBA assistance. SBA may also use social security numbers for the purpose of
collecting and reporting on any delinquent fees or other amounts owed SBA. Under the provisions of 31 U.S.C. 7701, the
applicant business and any guarantor of the loan are required to provide their social security numbers or other taxpayer
identification numbers in order to do business with SBA. Failure to provide this information would affect your ability to
obtain a 7(a) loan. For other individuals signing this application, the submission of the social security number is
voluntary and failure to provide your social security number may not affect any right, benefit or privilege to which you
are entitled.
In evaluating whether the applicant satisfies the criteria for a 7(a) loan, SBA considers whether the applicant and each of
its Associates possess good character. In making this determination, SBA considers the person's integrity, candor, and
criminal history if any. SBA is specifically authorized to verify your criminal history, or lack thereof, pursuant to section
7(a)(1)(B), of the Small Business Act, 15 USC Section 636(a)(1)(B). In addition, for all forms of assistance, SBA is
authorized to make all investigations necessary to ensure that a person has not engaged in acts that violate or will violate
the Small Business Act, 15 U.S.C. 634(b)(11). In conducting the criminal background check, SBA also uses your social
security number to distinguish you from other individuals with the same or similar name or other personal identifiers.
This use is permitted under Executive Order 9397.
Routine Uses: Some of the information collected may be checked against criminal history indices of the Federal Bureau
of Investigation. When the information collected 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. See SBA's Privacy Act System of Records, at 74 Fed. Reg. 14890 (2009) (as amended from time to
time) for other published r
Right to Financial Privacy Act of 1978 (12 U.S.C. 3401) -- As required by this statute, SBA provides this notice of its
right to access your financial records held by financial institutions, including any institution participating in a loan or
loan guarantee, that are or have been doing business with you or your business. The law provides that SBA shall have a
right of access to your financial records in connection with its consideration or administration of assistance to you in the
form of a Government loan or loan guaranty agreement. SBA is required to 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, after which no
further certification is required for subsequent access. The law also provides that SBA's access rights continue for the
term of any approved loan or loan guaranty agreement. No further notice to you of SBA's access rights is required during
the term of any such agreement.
The law also authorizes SBA to transfer to another Government authority any financial records included in an application
for a loan, or concerning an approved loan or loan guarantee, as necessary to process, service or foreclose on a loan or
loan guarantee or to collect on a defaulted loan or loan guarantee. No other transfer of your financial records to another
Government authority will be permitted by SBA except as required or permitted by law.
Freedom of Information Act (5 U.S.C. 552) -- This law provides, with some exceptions, that SBA must supply
information reflected in agency files and records to a person requesting it. Information about approved loans that is
generally 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 the amount of the loan, and the type of loan.
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.