This form contains 235 fields organized into 34 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name	Type	Description
Applicant Information
Please type the applicant's gender code here	Text	Enter the gender code of the applicant. Refer to the provided list of gender codes to find the appropriate code.
Please type the applicant's race code here. Applicant can type more than one code	Text	Enter the race code(s) of the applicant. You can enter more than one code if applicable. Refer to the provided list of race codes to find the appropriate codes.
Please type the applicant's ethnicity code here	Text	Enter the ethnicity code of the applicant. Refer to the provided list of ethnicity codes to find the appropriate code.
Business Information
If the applicant business is an operating company, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant business is an operating company.
If the applicant business is an eligible passive company, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant business is an eligible passive company.
Please type the applicant business's legal name here	Text	Enter the legal name of the applicant business.
Please type the operating business or OC's legal name here	Text	Enter the legal name of the operating business or operating company (OC).
If applicable, please type the DBA or trade name here	Text	If applicable, enter the DBA (Doing Business As) or trade name of the applicant business.
Please type the Applicant's primary business address here	Text	Enter the primary business address of the applicant.
Please type the Applicant's business tax ID here	Text	Enter the business tax ID of the applicant.
Please type the Applicant's primary business phone number here	Text	Enter the primary business phone number of the applicant.
If the Applicant has any Affiliates per 13 CFR 121.301, please check this box by clicking or pressing the space bar or Enter key. If "Yes", attach a listing of all affiliates	CheckBox	Check this box if the applicant has any affiliates as defined by 13 CFR 121.301. If checked, attach a listing of all affiliates.
If the Applicant does not have any Affiliates per 13 CFR 121.301, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant does not have any affiliates as defined by 13 CFR 121.301.
If the Applicant and/or its Affiliates has ever filed for bankruptcy protection, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant or its affiliates have ever filed for bankruptcy protection.
If the Applicant and/or its Affiliates has never filed for bankruptcy protection, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant or its affiliates have never filed for bankruptcy protection.
If the Applicant and/or its Affiliates is presently involved in any pending legal action, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant or its affiliates are presently involved in any pending legal action.
If the Applicant and/or its Affiliates is not presently involved in any pending legal action, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant or its affiliates are not presently involved in any pending legal action.
If any of the Applicant's products and/or services are exported (directly or indirectly), there is a plan to begin exporting (directly or indirectly) as a result of this loan, or this is an Export Working Capital Program (EWCP) loan, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if any of the applicant's products or services are exported, there is a plan to begin exporting as a result of this loan, or this is an Export Working Capital Program (EWCP) loan.
If none of the Applicant's products and/or services are exported (directly or indirectly), there is no plan to begin exporting (directly or indirectly) as a result of this loan, and this is not an Export Working Capital Program (EWCP) loan, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if none of the applicant's products or services are exported, there is no plan to begin exporting as a result of this loan, and this is not an Export Working Capital Program (EWCP) loan.
Please type the total export sales this loan will support here	Text	Enter the total export sales that this loan will support.
Please type the first principal country of export here	Text	Enter the first principal country of export.
Please type the second principal country of export here	Text	Enter the name of the second principal country where your business exports its products or services.
Please type the third principal country of export here	Text	Enter the name of the third principal country where your business exports its products or services.
If any of the Applicant's revenues are derived from gambling, loan packaging, or from the sale of products or services, or the presentation of any depiction, displays, or live performances, of a prurient sexual nature, please check this box by clicking or pressing the space bar or Enter key. If "Yes," provide details under a separate attachment	CheckBox	Check this box if any of the applicant's revenues come from gambling, loan packaging, or the sale of products or services, or the presentation of any depiction, displays, or live performances of a prurient sexual nature. If 'Yes,' provide details in a separate attachment.
If none of the Applicant's revenues are derived from gambling, loan packaging, or from the sale of products or services, or the presentation of any depiction, displays, or live performances, of a prurient sexual nature, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if none of the applicant's revenues come from gambling, loan packaging, or the sale of products or services, or the presentation of any depiction, displays, or live performances of a prurient sexual nature.
If any employee, owner, partner, attorney, agent, owner of the stock, officer, director, creditor or debtor of the Applicant is a former SBA employee who has been separated from SBA for less than one year prior to the request for financial assistance, please check this box by clicking or pressing the space bar or Enter key. If "Yes," please provide details on a separate sheet	CheckBox	Check this box if any employee, owner, partner, attorney, agent, owner of the stock, officer, director, creditor, or debtor of the Applicant is a former SBA employee who has been separated from SBA for less than one year prior to the request for financial assistance. If 'Yes,' provide details on a separate sheet.
If no employee, owner, partner, attorney, agent, owner of the stock, officer, director, creditor or debtor of the Applicant is a former SBA employee who has been separated from SBA for less than one year prior to the request for financial assistance, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if no employee, owner, partner, attorney, agent, owner of the stock, officer, director, creditor, or debtor of the Applicant is a former SBA employee who has been separated from SBA for less than one year prior to the request for financial assistance.
If any sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest in the Applicant, or a household member of such individual, is a member of Congress, or an appointed official or employee of the legislative or judicial branch of the Federal Government, please check this box by clicking or pressing the space bar or Enter key. If "Yes," please provide details on a separate sheet	CheckBox	Check this box if any sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest in the Applicant, or a household member of such individual, is a member of Congress, or an appointed official or employee of the legislative or judicial branch of the Federal Government. If 'Yes,' provide details on a separate sheet.
If no sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest in the Applicant, or a household member of such individual, is a member of Congress, or an appointed official or employee of the legislative or judicial branch of the Federal Government, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if no sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest in the Applicant, or a household member of such individual, is a member of Congress, or an appointed official or employee of the legislative or judicial branch of the Federal Government.
If any sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest in the Applicant, or a household member of such individual, is a Federal Government employee or Member of the Military having a grade of at least GS-13 or higher (or military equivalent), please check this box by clicking or pressing the space bar or Enter key. If "Yes," please provide details on a separate sheet	CheckBox	Check this box if any sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest in the Applicant, or a household member of such individual, is a Federal Government employee or Member of the Military having a grade of at least GS-13 or higher (or military equivalent). If 'Yes,' provide details on a separate sheet.
If no sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest in the Applicant, or a household member of such individual, is a Federal Government employee or Member of the Military having a grade of at least GS-13 or higher (or military equivalent), please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if no sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest in the Applicant, or a household member of such individual, is a Federal Government employee or Member of the Military having a grade of at least GS-13 or higher (or military equivalent).
If any sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest in the Applicant, or a household member of such an individual, is a member or employee of a Small Business Advisory Council or a SCORE volunteer, please check this box by clicking or pressing the space bar or Enter key. If "Yes," please provide details on a separate sheet	CheckBox	Check this box if any sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest in the Applicant, or a household member of such an individual, is a member or employee of a Small Business Advisory Council or a SCORE volunteer. If 'Yes,' provide details on a separate sheet.
If no sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest in the Applicant, or a household member of such an individual, is a member or employee of a Small Business Advisory Council or a SCORE volunteer, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if no sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest in the Applicant, or a household member of such an individual, is a member or employee of a Small Business Advisory Council or a SCORE volunteer.
Please type the Applicant's legal name here	Text	Enter the legal name of the applicant business.
Business Structure
If the Applicant Business operates under a Franchise/License/Distributor/Membership/Dealer/ Jobber or other type of Agreement, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the Applicant Business operates under a Franchise/License/Distributor/Membership/Dealer/Jobber or other type of Agreement.
If the Applicant Business does not operate under a Franchise/License/Distributor/Membership/Dealer/ Jobber or other type of Agreement, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the Applicant Business does not operate under a Franchise/License/Distributor/Membership/Dealer/Jobber or other type of Agreement.
Business Type
If the applicant is a cooperative, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant is a cooperative.
If the applicant is an ESOP, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant is an Employee Stock Ownership Plan (ESOP).
If the applicant is a 401 (k) plan, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant is a 401(k) plan.
If the applicant is a trust, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant is a trust.
If the applicant is other than a cooperative, ESOP, 401 (k) plan, or trust, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant is other than a cooperative, ESOP, 401(k) plan, or trust.
If the question of the applicant's type is not applicable, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the question of the applicant's type is not applicable.
Citizenship Information
If you are a U S citizen, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you are a U.S. citizen.
If you have Lawful Permanent Resident status, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you have Lawful Permanent Resident status.
If you are not a U S citizen or Lawful Permanent Resident, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you are not a U.S. citizen or Lawful Permanent Resident.
Please type your USCIS registration number here	Text	Enter your USCIS registration number.
Please type your country of citizenship here	Text	Enter your country of citizenship.
Compliance
If the Applicant is presently suspended, debarred, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the Applicant is presently suspended, debarred, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency.
If the Applicant is not presently suspended, debarred, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the Applicant is not presently suspended, debarred, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency.
If any sole proprietor, partner, officer, director, a stockholder with a 10 percent or more interest in the Applicant is an SBA employee or a Household member of an SBA employee, please check this box by clicking or pressing the space bar or Enter key. If "Yes," please provide details on a separate sheet	CheckBox	Check this box if any sole proprietor, partner, officer, director, or stockholder with a 10 percent or more interest in the applicant is an SBA employee or a household member of an SBA employee. If 'Yes,' provide details on a separate sheet.
If no sole proprietor, partner, officer, director, a stockholder with a 10 percent or more interest in the Applicant is an SBA employee or a Household member of an SBA employee, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if no sole proprietor, partner, officer, director, or stockholder with a 10 percent or more interest in the applicant is an SBA employee or a household member of an SBA employee.
Contact Information
Please type the primary contact's name here	Text	Enter the name of the primary contact person.
Please type the primary contact's email address here	Text	Enter the email address of the primary contact person.
Criminal History
If you are presently subject to an indictment, criminal information, arraignment, or other means by which formal criminal charges are brought in any jurisdiction, please check this box by clicking or pressing the space bar or Enter key. If "YES," the loan request is not eligible for SBA assistance	CheckBox	Check this box if you are currently subject to an indictment, criminal information, arraignment, or other formal criminal charges in any jurisdiction. Note: If 'YES,' the loan request is not eligible for SBA assistance.
If you are not presently subject to an indictment, criminal information, arraignment, or other means by which formal criminal charges are brought in any jurisdiction, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you are not currently subject to an indictment, criminal information, arraignment, or other formal criminal charges in any jurisdiction.
If you have been arrested in the last 6 months for any criminal offense, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you have been arrested for any criminal offense in the last 6 months.
If you have not been arrested in the last 6 months for any criminal offense, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you have not been arrested for any criminal offense in the last 6 months.
For any criminal offense other than a minor vehicle violation, if you have ever: 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), please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you have ever been convicted, pleaded guilty, pleaded nolo contendere, been placed on pretrial diversion, or been placed on any form of parole or probation (including probation before judgment) for any criminal offense other than a minor vehicle violation.
For any criminal offense other than a minor vehicle violation, if you have never been convicted, pleaded guilty, pleaded nolo contendere, placed on pretrial diversion, nor placed on any form of parole or probation (including probation before judgment), please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you have never been convicted, pleaded guilty, pleaded nolo contendere, placed on pretrial diversion, nor placed on any form of parole or probation for any criminal offense other than a minor vehicle violation.
Delinquent Financing
If you answered "Yes" to Question 31, if any of the financing is presently considered delinquent, please check this box by clicking or pressing the space bar or Enter key. If you answer "Yes" to either 31(a) or 31(b), please provide the Lender with a written explanation	CheckBox	Check this box if you answered 'Yes' to Question 31 and any of the financing is currently considered delinquent. Provide the Lender with a written explanation if you answer 'Yes' to either 31(a) or 31(b).
If you answered "Yes" to Question 31, if none of the financing is presently considered delinquent, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you answered 'Yes' to Question 31 and none of the financing is currently considered delinquent.
Eligibility Status
If you are presently suspended, debarred, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency, please check this box by clicking or pressing the space bar or Enter key. If "Yes," please provide details on a separate sheet	CheckBox	Check this box if you are presently suspended, debarred, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency. If 'Yes,' provide details on a separate sheet.
If you are neither presently suspended, debarred, proposed for debarment, declared ineligible, nor voluntarily excluded from participation in this transaction by any federal department or agency, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you are neither presently suspended, debarred, proposed for debarment, declared ineligible, nor voluntarily excluded from participation in this transaction by any federal department or agency.
Employment Information
Please type the number of existing employees employed by the business (including owners) here	Text	Enter the number of existing employees employed by the business, including owners.
Entity Financial History
If the entity and/or its Affiliates never filed for bankruptcy protection, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the entity and/or its affiliates have never filed for bankruptcy protection.
Entity Information
If the entity, or any of its owners, is presently suspended, debarred, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency, please check this box by clicking or pressing the space bar or Enter key. If "Yes," please provide details on a separate sheet	CheckBox	Check this box if the entity or any of its owners is currently suspended, debarred, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. Provide details on a separate sheet if 'Yes'.
If the entity, or any of its owners, is not presently suspended, debarred, proposed for debarment, declared ineligible, nor voluntarily excluded from participation in this transaction by any Federal department or agency, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the entity or any of its owners is not currently suspended, debarred, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency.
If the entity has any Affiliates, please check this box by clicking or pressing the space bar or Enter key. If "Yes," attach a listing of all affiliates	CheckBox	Check this box if the entity has any affiliates. Attach a listing of all affiliates if 'Yes'.
If the entity does not have any Affiliates, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the entity does not have any affiliates.
If the entity and/or its Affiliates ever filed for bankruptcy protection, please check this box by clicking or pressing the space bar or Enter key. If "Yes," please provide details on a separate sheet	CheckBox	Check this box if the entity and/or its affiliates have ever filed for bankruptcy protection. Provide details on a separate sheet if 'Yes'.
Entity Owner Information
Please type the entity owner's legal name here	Text	Enter the legal name of the entity owner.
Please type the entity owner's tax ID here	Text	Enter the tax ID of the entity owner.
Please type the entity owner's phone number here	Text	Enter the phone number of the entity owner.
Please type the entity owner's address here	Text	Enter the address of the entity owner.
Please type the entity owner's primary contact name here	Text	Enter the primary contact name for the entity owner.
Please type the entity owner's email address here	Text	Enter the email address of the entity owner.
If the entity owner is completing Section 3 as a 401(k) plan, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the entity owner is completing Section 3 as a 401(k) plan.
If the entity owner is completing Section 3 as an ESOP, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the entity owner is completing Section 3 as an ESOP.
If the entity owner is completing Section 3 as other than a 401(k) plan or an ESOP, please check this box by clicking or pressing the space bar or Enter key. Please explain in a separate attachment	CheckBox	Check this box if the entity owner is completing Section 3 as other than a 401(k) plan or an ESOP. Please explain in a separate attachment.
Equity Information
If the applicant plans to use a 401(K) Plan (including a Rollover for Business Start-Up (ROBS) Plan) for equity, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant plans to use a 401(K) Plan, including a Rollover for Business Start-Up (ROBS) Plan, for equity.
If the applicant does not plan to use a 401(K) Plan (including a Rollover for Business Start-Up (ROBS) Plan) for equity, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant does not plan to use a 401(K) Plan, including a Rollover for Business Start-Up (ROBS) Plan, for equity.
Government Loan Default
If you answered "Yes" to Question 31, if any loan that was for a business purpose ever defaulted and caused a loss to the government, including a compromise, resolution, or settlement of a loan's principal balance for less than the full amount due, please check this box by clicking or pressing the space bar or Enter key. If you answer "Yes" to either 31(a) or 31(b), please provide the Lender with a written explanation	CheckBox	Check this box if you answered 'Yes' to Question 31 and any loan for a business purpose ever defaulted and caused a loss to the government, including a compromise, resolution, or settlement of a loan's principal balance for less than the full amount due. Provide the Lender with a written explanation if you answer 'Yes' to either 31(a) or 31(b).
Individual Owner Information
Please type the individual owner's full legal name here	Text	Enter the full legal name of the individual owner.
Please type the individual owner's Social Security or tax ID number here	Text	Enter the Social Security or tax ID number of the individual owner.
Please type the individual owner's date of birth in 2 digit month / 2 digit day / 4 digit year format here	Text	Enter the date of birth of the individual owner in the format MM/DD/YYYY.
Please type the individual owner's place of birth (city, state, and country) here	Text	Enter the place of birth (city, state, and country) of the individual owner.
Please type the individual owner's home address here	Text	Enter the home address of the individual owner.
Please type the individual owner's home phone number here	Text	Enter the home phone number of the individual owner.
Please type the individual owner's ownership percentage here	Text	Enter the ownership percentage of the individual owner.
Please type the Applicant's legal name here	Text	Enter the legal name of the Applicant.
Please type the first owner's legal name here	Text	Enter the legal name of the first owner.
Please type the first owner's title here	Text	Enter the title of the first owner.
Please type the first owner's ownership percentage here	Text	Enter the ownership percentage of the first owner.
Please type the first owner's TIN (SSN or EIN) here	Text	Enter the TIN (SSN or EIN) of the first owner.
Legal Status
If the entity and/or its Affiliates are presently involved in any pending legal action, please check this box by clicking or pressing the space bar or Enter key. If "Yes," please provide details on a separate sheet	CheckBox	Check this box if the entity and/or its affiliates are currently involved in any pending legal action. If 'Yes,' provide details on a separate sheet.
If the entity and/or its Affiliates are not presently involved in any pending legal action, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the entity and/or its affiliates are not currently involved in any pending legal action.
Loan Default
If you answered "Yes" to Question 26, if any loan that was made for business purposes ever defaulted and caused a loss to the Government, including a compromise, resolution or settlement of a loan's principal balance for less than the full amount due, please check this box by clicking or pressing the space bar or Enter key. If you answer "Yes" to either 26(a) or 26(b), please provide the lender with a written explanation	CheckBox	Check this box if you answered 'Yes' to Question 26 and any loan made for business purposes ever defaulted and caused a loss to the Government, including a compromise, resolution, or settlement of a loan's principal balance for less than the full amount due. Provide the lender with a written explanation if you answer 'Yes' to either 26(a) or 26(b).
If you answered "Yes" to Question 26, if no loan that was made for business purposes ever defaulted and caused a loss to the Government, including a compromise, resolution or settlement of a loan's principal balance for less than the full amount due, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you answered 'Yes' to Question 26 and no loan made for business purposes ever defaulted and caused a loss to the Government, including a compromise, resolution, or settlement of a loan's principal balance for less than the full amount due.
Loan Delinquency
If you answered "Yes" to Question 26, if any of the financing is presently considered delinquent, please check this box by clicking or pressing the space bar or Enter key. If you answer "Yes" to either 26(a) or 26(b), please provide the lender with a written explanation	CheckBox	Check this box if you answered 'Yes' to Question 26 and any of the financing is presently considered delinquent. Provide the lender with a written explanation if you answer 'Yes' to either 26(a) or 26(b).
If you answered "Yes" to Question 26, if none of the financing is presently considered delinquent, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you answered 'Yes' to Question 26 and none of the financing is presently considered delinquent.
Loan Details
Please type the first loan amount here	Text	Enter the amount of the first loan you are requesting.
Please type the purpose of the first loan here	Text	Enter the purpose for which the first loan amount will be used.
Please type the second loan amount here	Text	Enter the amount of the second loan you are requesting.
Please type the purpose of the second loan here	Text	Enter the purpose for which the second loan amount will be used.
Please type the third loan amount here	Text	Enter the amount of the third loan you are requesting.
Please type the purpose of the third loan here	Text	Enter the purpose for which the third loan amount will be used.
Please type the fourth loan amount here	Text	Enter the amount of the fourth loan you are requesting.
Please type the purpose of the fourth loan here	Text	Enter the purpose for which the fourth loan amount will be used.
Please type the fifth loan amount here	Text	Enter the amount of the fifth loan you are requesting.
Please type the purpose of the fifth loan here	Text	Enter the purpose for which the fifth loan amount will be used.
Please type the sixth loan amount here	Text	Enter the amount of the sixth loan you are requesting.
Please type the purpose of the sixth loan here	Text	Enter the purpose for which the sixth loan amount will be used.
Loan History
If the Applicant and/or its Affiliates has ever obtained or applied for a direct or guaranteed loan from SBA, or another federal agency loan program, or been a guarantor on such a loan, and any of the financing is currently delinquent, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the Applicant and/or its Affiliates has ever obtained or applied for a direct or guaranteed loan from SBA, or another federal agency loan program, or been a guarantor on such a loan, and any of the financing is currently delinquent.
If the Applicant and/or its Affiliates has ever obtained or applied for a direct or guaranteed loan from SBA, or another federal agency loan program, or been a guarantor on such a loan, and none of the financing is currently delinquent, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the Applicant and/or its Affiliates has ever obtained or applied for a direct or guaranteed loan from SBA, or another federal agency loan program, or been a guarantor on such a loan, and none of the financing is currently delinquent.
If the Applicant and/or its Affiliates has ever obtained or applied for a direct or guaranteed loan from SBA, or another federal agency loan program, or been a guarantor on such a loan, and if any of this financing ever defaulted and caused a loss to the Federal Government, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the Applicant and/or its Affiliates has ever obtained or applied for a direct or guaranteed loan from SBA, or another federal agency loan program, or been a guarantor on such a loan, and if any of this financing ever defaulted and caused a loss to the Federal Government.
If the Applicant and/or its Affiliates has ever obtained or applied for a direct or guaranteed loan from SBA, or another federal agency loan program, or been a guarantor on such a loan, and if none of this financing ever defaulted and caused a loss to the Federal Government, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the Applicant and/or its Affiliates has ever obtained or applied for a direct or guaranteed loan from SBA, or another federal agency loan program, or been a guarantor on such a loan, and if none of this financing ever defaulted and caused a loss to the Federal Government.
If you or any business owned or controlled by you have ever obtained a direct or guaranteed loan from SBA or any other federal agency or been a guarantor on such a loan, please check this box by clicking or pressing the space bar or Enter key. If "Yes," please provide details on a separate sheet	CheckBox	Check this box if you or any business you own or control have ever obtained a direct or guaranteed loan from SBA or any other federal agency, or have been a guarantor on such a loan. If 'Yes,' provide details on a separate sheet.
If you or any business owned or controlled by you have never obtained a direct or guaranteed loan from SBA nor any other federal agency or been a guarantor on such a loan, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you or any business you own or control have never obtained a direct or guaranteed loan from SBA or any other federal agency, nor have been a guarantor on such a loan.
If you answered "Yes" to Question 31, if no loan that was for a business purpose ever defaulted and caused a loss to the government, including a compromise, resolution, or settlement of a loan's principal balance for less than the full amount due, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you answered 'Yes' to Question 31 and no loan for a business purpose ever defaulted and caused a loss to the government, including any compromise, resolution, or settlement of a loan's principal balance for less than the full amount due.
Loan Impact
Please type the number of jobs created as a result of the loan here	Text	Enter the number of jobs that will be created as a result of receiving the loan.
Please type the number of jobs that will be retained as a result of a loan that otherwise would have been lost here	Text	Enter the number of jobs that will be retained as a result of receiving the loan, which otherwise would have been lost.
Loan Request
Please type the amount of the requested loan here	Text	Enter the amount of the loan being requested.
If the Applicant has paid or committed to pay a fee to the Lender or a third party to assist in the preparation of the loan application or application materials, or the Applicant has paid or committed to pay a referral agent or broker a fee, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant has paid or committed to pay a fee to the lender or a third party for assistance in preparing the loan application or materials, or if a referral agent or broker has been paid or will be paid a fee.
If the Applicant has not paid or committed to pay a fee to the Lender or a third party to assist in the preparation of the loan application or application materials, and the Applicant has not paid or committed to pay a referral agent or broker a fee, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant has not paid or committed to pay a fee to the lender or a third party for assistance in preparing the loan application or materials, and if no referral agent or broker has been paid or will be paid a fee.
Loan Request Information
If there are any co-applicants, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if there are any co-applicants for the loan.
If there are no co-applicants, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if there are no co-applicants for the loan.
If an application for the requested loan has ever been submitted to the SBA, a lender, or a Certified Development Company, in connection with an SBA program, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if an application for the requested loan has ever been submitted to the SBA, a lender, or a Certified Development Company in connection with an SBA program.
If an application for the requested loan has never been submitted to the SBA, a lender, or a Certified Development Company, in connection with an SBA program, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if an application for the requested loan has never been submitted to the SBA, a lender, or a Certified Development Company in connection with an SBA program.
If the Applicant and/or its Affiliates has ever obtained or applied for a direct or guaranteed loan from SBA, or another federal agency loan program (including, but not limited to USDA, B&I, FSA, EDA), or been a guarantor on such a loan, please check this box by clicking or pressing the space bar or Enter key. if "Yes," answer questions 3.a) and 3.b) below	CheckBox	Check this box if the applicant and/or its affiliates has ever obtained or applied for a direct or guaranteed loan from SBA, or another federal agency loan program (including, but not limited to USDA, B&I, FSA, EDA), or been a guarantor on such a loan. If 'Yes,' answer questions 3.a) and 3.b) below.
If the applicant and/or its Affiliates has never obtained or applied for a direct or guaranteed loan from SBA, or another federal agency loan program (including, but not limited to USDA, B&I, FSA, EDA), or been a guarantor on such a loan, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant and/or its affiliates has never obtained or applied for a direct or guaranteed loan from SBA, or another federal agency loan program (including, but not limited to USDA, B&I, FSA, EDA), or been a guarantor on such a loan.
Management Information
If a management company will be hired by the applicant to manage the day-to-day operations, please check this box by clicking or pressing the space bar or Enter key. If yes, provide a copy of the management agreement	CheckBox	Check this box if the applicant will hire a management company to manage day-to-day operations. If yes, provide a copy of the management agreement.
If a management company will not be hired by the applicant to manage the day-to-day operations, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the applicant will not hire a management company to manage day-to-day operations.
Owner Information
Please type the first owner's legal name here	Text	Enter the full legal name of the first owner of the business.
Please type the first owner's title here	Text	Enter the title or position of the first owner within the business.
Please type the first owner's ownership percentage here	Text	Enter the ownership percentage held by the first owner in the business.
Please type the first owner's TIN (SSN or EIN) here	Text	Enter the Tax Identification Number (TIN), which can be either the Social Security Number (SSN) or Employer Identification Number (EIN) of the first owner.
Please type the line 1 of the first owner's address here	Text	Enter the first line of the address for the first owner.
Please type line 2 of the first owner's address here	Text	Enter the second line of the address for the first owner, if applicable.
If the first owner is an ESOP, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the first owner is an Employee Stock Ownership Plan (ESOP).
If the first owner is a 401 (k) plan, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the first owner is a 401(k) plan.
If the first owner is a cooperative, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the first owner is a cooperative.
Please type the second owner's legal name here	Text	Enter the full legal name of the second owner of the business.
Please type the second owner's title here	Text	Enter the title or position of the second owner within the business.
Please type the second owner's ownership percentage here	Text	Enter the ownership percentage held by the second owner in the business.
Please type the second owner's TIN (SSN or EIN) here	Text	Enter the Tax Identification Number (TIN), which can be either the Social Security Number (SSN) or Employer Identification Number (EIN) of the second owner.
Please type line 1 of the second owner's address here	Text	Enter the first line of the address for the second owner.
Please type line 2 of the second owner's address here	Text	Please enter the second line of the address for the second owner.
If the second owner is an ESOP, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the second owner is an Employee Stock Ownership Plan (ESOP).
If the second owner is a 401 (k) plan, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the second owner is a 401(k) plan.
If the second owner is a cooperative, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the second owner is a cooperative.
Please type the third owner's legal name here	Text	Please enter the legal name of the third owner.
Please type the third owner's title here	Text	Please enter the title of the third owner.
Please type the third owner's ownership percentage here	Text	Please enter the ownership percentage of the third owner.
Please type the third owner's TIN (SSN or EIN) here	Text	Please enter the Taxpayer Identification Number (TIN) of the third owner, which can be either a Social Security Number (SSN) or Employer Identification Number (EIN).
Please type line 1 of the third owner's address here	Text	Please enter the first line of the address for the third owner.
Please type line 2 of the third owner's address here	Text	Please enter the second line of the address for the third owner.
If the third owner is an ESOP, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the third owner is an Employee Stock Ownership Plan (ESOP).
If the third owner is a 401 (k) plan, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the third owner is a 401(k) plan.
If the third owner is a cooperative, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the third owner is a cooperative.
Please type the fourth owner's legal name here	Text	Enter the full legal name of the fourth owner of the business.
Please type the fourth owner's title here	Text	Enter the title or position of the fourth owner within the business.
Please type the fourth owner's ownership percentage here	Text	Enter the ownership percentage held by the fourth owner in the business.
Please type the fourth owner's TIN (SSN or EIN) here	Text	Enter the Tax Identification Number (TIN), which can be either the Social Security Number (SSN) or Employer Identification Number (EIN), of the fourth owner.
Please type line 1 of the fourth owner's address here	Text	Enter the first line of the address for the fourth owner.
Please type line 2 of the fourth owner's address here	Text	Enter the second line of the address for the fourth owner, if applicable.
If the fourth owner is an ESOP, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the fourth owner is an Employee Stock Ownership Plan (ESOP).
If the fourth owner is a 401 (k) plan, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the fourth owner is a 401(k) plan.
If the fourth owner is a cooperative, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the fourth owner is a cooperative.
Please type the fifth owner's legal name here	Text	Enter the full legal name of the fifth owner of the business.
Please type the fifth owner's title here	Text	Enter the title or position of the fifth owner within the business.
Please type the fifth owner's ownership percentage here	Text	Enter the ownership percentage held by the fifth owner in the business.
Please type the fifth owner's TIN (SSN or EIN) here	Text	Enter the Tax Identification Number (TIN), which can be either the Social Security Number (SSN) or Employer Identification Number (EIN), of the fifth owner.
Please type line 1 of the fifth owner's address here	Text	Enter the first line of the address for the fifth owner.
Please type line 2 of the fifth owner's address here	Text	Please provide the second line of the address for the fifth owner of the applicant business.
If the fifth owner is an ESOP, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the fifth owner of the applicant business is an Employee Stock Ownership Plan (ESOP).
If the fifth owner is a 401 (k) plan, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the fifth owner of the applicant business is a 401(k) plan.
If the fifth owner is a cooperative, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the fifth owner of the applicant business is a cooperative.
If you are a 50% or more owner of the Applicant, you are more than 60 days delinquent on any obligation to pay child support arising under an administrative order, court order, repayment agreement between the holder and a custodial parent, or repayment agreement between the holder and a state agency providing child support enforcement services, please check this box by clicking or pressing the space bar or Enter key. If "Yes," please provide details on a separate sheet	CheckBox	Check this box if you are a 50% or more owner of the Applicant and are more than 60 days delinquent on any child support obligation. If 'Yes,' provide details on a separate sheet.
If you are a 50% or more owner of the Applicant and you are not more than 60 days delinquent on any obligation to pay child support arising under an administrative order, court order, repayment agreement between the holder and a custodial parent, nor repayment agreement between the holder and a state agency providing child support enforcement services, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you are a 50% or more owner of the Applicant and are not more than 60 days delinquent on any child support obligation.
If you have any ownership in other businesses that would be defined as an Affiliate of the Applicant in the definition found on page 1, please check this box by clicking or pressing the space bar or Enter key. If "Yes," attach a listing of all businesses, your title and ownership percentage in the business	CheckBox	Check this box if you have any ownership in other businesses that would be defined as an Affiliate of the Applicant. If 'Yes,' attach a listing of all businesses, your title, and ownership percentage in each business.
If you do not have any ownership in other businesses that would be defined as an Affiliate of the Applicant in the definition found on page 1, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you do not have any ownership in other businesses that would be defined as an Affiliate of the Applicant.
If you, or any business you controlled, have ever filed for bankruptcy protection, please check this box by clicking or pressing the space bar or Enter key. If yes, provide details	CheckBox	Check this box if you, or any business you controlled, have ever filed for bankruptcy protection. If 'Yes,' provide details.
If you, or any business you controlled, have never filed for bankruptcy protection, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you, or any business you controlled, have never filed for bankruptcy protection.
If you, or any business you control, are presently involved in any legal action (including divorce), please check this box by clicking or pressing the space bar or Enter key. If yes, provide details	CheckBox	Check this box if you, or any business you control, are presently involved in any legal action (including divorce). If 'Yes,' provide details.
If you, or any business you control, are not presently involved in any legal action (including divorce), please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if you, or any business you control, are not presently involved in any legal action (including divorce).
Please type line 1 of the first owner's address here	Text	Enter the first line of the first owner's address.
Please type line 2 of the first owner's address here	Text	Enter the second line of the first owner's address, if applicable.
If the first owner is an ESOP, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the first owner is an Employee Stock Ownership Plan (ESOP).
If the first owner is a 401(k) plan, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the first owner is a 401(k) plan.
If the first owner is a cooperative, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the first owner is a cooperative.
Please type the second owner's legal name here	Text	Enter the legal name of the second owner.
Please type the second owner's title here	Text	Enter the title of the second owner within the business.
Please type the second owner's ownership percentage here	Text	Enter the ownership percentage of the second owner.
Please type the second owner's TIN (SSN or EIN) here	Text	Enter the Taxpayer Identification Number (TIN) of the second owner, which can be either a Social Security Number (SSN) or Employer Identification Number (EIN).
Please type line 1 of the second owner's address here	Text	Enter the first line of the second owner's address.
Please type line 2 of the second owner's address here	Text	Enter the second line of the second owner's address, if applicable.
If the second owner is an ESOP, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the second owner is an Employee Stock Ownership Plan (ESOP).
If the second owner is a 401(k) plan, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the second owner is a 401(k) plan.
If the second owner is a cooperative, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the second owner is a cooperative.
Please type the third owner's legal name here	Text	Enter the legal name of the third owner.
Please type the third owner's title here	Text	Enter the title of the third owner.
Please type the third owner's ownership percentage here	Text	Enter the ownership percentage of the third owner.
Please type the third owner's TIN (SSN or EIN) here	Text	Enter the TIN (SSN or EIN) of the third owner.
Please type line 1 of the third owner's address here	Text	Enter the first line of the third owner's address.
Please type line 2 of the third owner's address here	Text	Enter the second line of the third owner's address.
If the third owner is an ESOP, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the third owner is an ESOP.
If the third owner is a 401(k) plan, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the third owner is a 401(k) plan.
If the third owner is a cooperative, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the third owner is a cooperative.
Please type the fourth owner's legal name here	Text	Enter the legal name of the fourth owner.
Please type the fourth owner's title here	Text	Enter the title of the fourth owner.
Please type the fourth owner's ownership percentage here	Text	Enter the ownership percentage of the fourth owner.
Please type the fourth owner's TIN (SSN or EIN) here	Text	Enter the TIN (SSN or EIN) of the fourth owner.
Please type line 1 of the fourth owner's address here	Text	Enter the first line of the address for the fourth owner of the applicant business.
Please type line 2 of the fourth owner's address here	Text	Enter the second line of the address for the fourth owner of the applicant business.
If the fourth owner is an ESOP, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the fourth owner is an Employee Stock Ownership Plan (ESOP).
If the fourth owner is a 401(k) plan, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the fourth owner is a 401(k) plan.
If the fourth owner is a cooperative, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the fourth owner is a cooperative.
Previous Government Financing
If the entity has ever obtained a direct or guaranteed loan from SBA or any other Federal agency or been a guarantor on such a loan, please check this box by clicking or pressing the space bar or Enter key. If "Yes," please provide details on a separate sheet	CheckBox	Check this box if the entity has ever obtained a direct or guaranteed loan from SBA or any other Federal agency, or been a guarantor on such a loan. If 'Yes,' provide details on a separate sheet.
If the entity has never obtained a direct or guaranteed loan from SBA or any other Federal agency or been a guarantor on such a loan, please check this box by clicking or pressing the space bar or Enter key	CheckBox	Check this box if the entity has never obtained a direct or guaranteed loan from SBA or any other Federal agency, or been a guarantor on such a loan.
Project Information
If the project address differs from the primary business address, please type the project address here	Text	If the project address is different from the primary business address, enter the project address here.
Signature
Please enter your digital signature here by pressing Enter	Signature	Enter your digital signature here by pressing Enter.
Please select or type the date of signature in 2 digit month / 2 digit day / 4 digit year format	Text	Select or type the date of signature in the format MM/DD/YYYY.
Please type your name and title here	Text	Type your name and title here.
Signature Confirmation
Please enter your digital signature here by pressing Enter, to confirm your response to question 19	Signature	Enter your digital signature to confirm your response to question 19.
Please enter your digital signature here by pressing Enter, to confirm your response to question 20	Signature	Enter your digital signature to confirm your response to question 20.
Signature Details
Please enter the Authorized Representative of Applicant's digital signature here by pressing Enter	Signature	Enter the digital signature of the Authorized Representative of the Applicant.
Please select or type the date of signature in 2 digit month / 2 digit day / 4 digit year format here	Text	Enter the date of signature in the format MM/DD/YYYY.
Please type the Authorized Representative of Applicant's name here	Text	Enter the name of the Authorized Representative of the Applicant.
Please type the Authorized Representative of Applicant's title here	Text	Enter the title of the Authorized Representative of the Applicant.
Please enter the Authorized Representative of Entity's digital signature here by pressing Enter	Signature	Enter the digital signature of the Authorized Representative of the Entity by pressing Enter.
Please select or type the date of signature in 2 digit month / 2 digit day / 4 digit year format	Text	Enter the date of signature in the format MM/DD/YYYY.
Please type the Authorized Representative of Entity's name and title here	Text	Type the name and title of the Authorized Representative of the Entity.
Signatures
Please enter your digital signature here by pressing Enter, to confirm your response to question 17	Signature	Enter your digital signature to confirm your response to question 17.
Please enter your digital signature here by pressing Enter, to confirm your response to question 18	Signature	Enter your digital signature to confirm your response to question 18.
Veteran, Gender, Race, and Ethnicity Information
Please type the applicant's veteran status code here	Text	Enter the veteran status code of the applicant.

Form SBA 1919, SBA 7(a) Borrower Info Instructions