218 W. Washington St. 10th Floor - South Bend, IN 46601 Ph: (574) 288-5758 - Fax: (574) 288-5759 Email: [email protected]

SBA 504 LOAN APPLICATION

Company Information Company Name _______________________________________________________________________ Address ________________________ City ____________________ State _______ Zip ______________ Principal in Charge ____________________________ Phone ________________ Fax _______________ Secondary Contact ____________________________ Phone ________________ Fax _______________ (IN-HOUSE CONTROLLER OR BOOKKEEPER)

Email ___________________________________

Type of Business ___________________________________ Date Established _____________________ Number of Existing Employees _______ Estimated # of new jobs to be created as a result of loan ______ Type of Entity (check one)

Proprietorship

Partnership

LLC

Corporation _____ (# of years incorporated)

Company Ownership NOTE: Any owners of 20% or more must be listed. If a corporation, please indicate who is President and Secretary. Operating Company: Name _______________________________ Title ____________________ % of Ownership _________ Name _______________________________ Title ____________________ % of Ownership _________ Name _______________________________ Title ____________________ % of Ownership _________ Holding Company: Name _______________________________ Title ____________________ % of Ownership _________ Name _______________________________ Title ____________________ % of Ownership _________ Name _______________________________ Title ____________________ % of Ownership _________

1

Additional Business Information List of Key Customers

List of Major Competitors

1. ___________________________________

1. ______________________________________

2. ___________________________________

2. ______________________________________

3. ___________________________________

3. ______________________________________

4. ___________________________________

4. ______________________________________

5. ___________________________________

5. ______________________________________

Please list any affiliate businesses (any businesses that potential guarantors own 20% or more of) Name ____________________________Owner _____________________ % of Ownership ________ Applicant Company or Individuals

Name ____________________________Owner _____________________ % of Ownership ________ Applicant Company or Individuals

Project Information Street Address of Project ________________________________________________________________ State _______________________ Zip ______________ County ________________________________ What is the square footage of new building? _____________________ What is the square footage that your company will occupy? _____________________ NOTE: The U.S. Small Business Administration requires that the borrowers of the 504 loan program occupy 51% of an existing building and 60% of a new building, initially. Total Project Costs Purchase Existing Building

Construction of New Building

Purchase Price $__________________________ Purchase of Land $___________________________ Building Improvements $___________________ Construction Bid $____________________________ Equipment Purchase $_____________________ Equipment Purchase $_________________________ Soft Costs $ _____________________________ Soft Costs $_________________________________ Other $__________________________________ Other $_____________________________________ TOTAL …………… $____________________ TOTAL………..………$______________________

2

Personal Information (any owner of 20% or more must fill out this page) Name __________________________________________________________________________________ First

Middle

Maiden

Last

Date of Birth ____/____/______ Place of Birth _________________________ Race ___________________ *Required (City and State)

Social Security No. __________________ U.S. Citizen?

Yes

No ____________________________

If “No” – Please provide alien registration #

Home Address _________________________ City _______________ State ________ Zip _____________ (Present) From _________________ To ____________ Phone: ______________________ Home

____________________ Business

Immediate Past Address _____________________ City _______________ State ________ Zip __________ From _________________ To _________________ NOTE: The following responses will not necessarily have an impact on your eligibility for SBA 504 financing. Are you presently under indictment, on parole or probation?

Yes

No

Have you ever been charged with and/or arrested for any criminal offense other than a minor motor vehicle violation? (If “Yes”, please describe in lines below) Yes No ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Have you ever been convicted, placed on pretrial diversion, or placed on any form of probation, including adjudication, withheld pending probation, for any criminal offense other than a minor motor vehicle violation? (If, “Yes”, please describe in lines below) Yes No ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Have you or any officer of your company ever been involved in bankruptcy or insolvency proceedings? (If, “Yes”, please describe in lines below) Yes No ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Are you or your business involved in any pending or prior lawsuits? (If, “Yes”, please describe in lines below) Yes No ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

3

Have you ever received an SBA loan?

Yes

No

Please check any of the following that pertain to your business: Woman Owned? Yes No Minority Owned?

Yes

No

Veteran Owned?

Yes

No

Borrower Fees Upfront fees included in Debenture, percentages are based on SBA 504 loan amount. • BDC Processing Fee: 1.5% • CSA Funding Fee: 0.25% $1,800 - $2,000 • Attorney Fee: • Underwriters Fee (20yr Debenture): 0.4% • Underwriters Fee (10yr Debenture): 0.375% Ongoing Servicing Fees included in the Debenture rated based on outstanding balance calculated into monthly amortization payment. • CSA Ongoing Servicing Fee: 0.10% • SBA Ongoing Guarantee Fee (traditional): 0.914% • BDC Ongoing Fee: 0.625% First Mortgage Lender Fee (Paid to Third Party Lender at, or prior to closing) • 0.5% Based on 1st Mortgage Loan Amount

Interest Rates The interest rate for 10 and 20 year Debentures is based on the market forces at the time the bond is sold. The payment will include principal and interest plus the additional ongoing servicing and guarantee fees. The current monthly interest rate and historical rates table for SBA 504 Debentures can be viewed at www.bdcloan.com.

Credit Report Authorization I declare that the information provided in this application is true and correct. I hereby authorize the release of any and all credit report and other information required in the processing of my loan application and as required in the servicing and/or during the term of my loan. I further authorize Business Development Corporation to release such information to any entity as required in the processing of my loan application. I/We hereby certify that the enclosed information, including any attachments or exhibits provided herewithin or at a later date, is valid and correct to the best of my/our knowledge. Signature ______________________________________________ Date ___________________ Spouse’s Signature ______________________________________ Date ___________________

4

Items Required in Order to Process Loan Financial Information 1. Tax Returns with supporting schedules for the past three (3) years for the operating company and holding company. 2. Interim Balance Sheet and Profit & Loss Statement (current within 120 days) for the operating company. 3. Tax Returns with supporting schedules for the past two (2) years on any business/trust in which any personal guarantor owns 20% or more. 4. Personal Financial Statement for anyone owning 20% or more of business (current within 90 days) 5. Tax Returns with supporting schedules for the past two (2) years for any individuals who have ownership in the business. Other Required Documentation 1. Complete attached Debt Schedule including all long term and/or notes payable. 2. Organization/Incorporation documents for business. 3. Attach a Business Summary describing the history and future plans for the business, in addition to project details and costs. 4. Signed Purchase Agreement and/or construction contract for real estate and invoices or estimates for equipment. 5. Appraisal and Environmental Reports are required before closing.

(BDC) APPLICATION AND DEPOSIT AGREEMENT DEPOSIT: Accompanying and prior to processing an application, a deposit in the amount of One Thousand Dollars ($1,000) must be made. The deposit is non-refundable upon the approval by the BDC Loan Committee. The deposit will be applied to costs to process the application and to any excess close costs. In the event the prospective Borrower elects to withdraw the application or declines to accept the loan commitment as stated in writing, the deposit will be retained to defray processing costs. Each application must be accompanied by this form, signed and dated by the Applicant, and a deposit of $1,000.00. By so doing, the applicant signified that he/she read, understands and accepts the terms, conditions and criteria stated. ____________________________________ Applicant

___________________________ Date

5

Current Full Time Employment # of Jobs

Job Title

Salary Range

Benefits

Salary Range

Benefits

Job Title

Salary Range

Benefits

Job Title

Salary Range

Benefits

Current Part Time Employment # of Jobs

Job Title

Projected New Hires during the next two years Full Time # of Jobs

Part Time # of Jobs

6

BUSINESS DEBT SCHEDULE Company Name ____________________________________ Date _________________ This schedule should include loans for contacts/notes payable and lines of credit, not accounts payable or accrued liabilities. Creditor Name / Address

Original Date

Original Amount

Term or Maturity Date

Present Balance

Interest Rate

Monthly Payment

Collateral Security

Reason For Loan

$

Total Present Balance (Total must agree with balance shown on Interim Balance sheet)

GOVERNMENT DEBT SCHEDULE (PAST OR CURRENT) Company Name ____________________________________ Date _________________ This schedule should include loans for contacts/notes payable and lines of credit, not accounts payable or accrued liabilities. Creditor Name / Address

Original Date

Original Amount

Term or Maturity Date

Present Balance

Interest Rate

Total Present Balance (Total must agree with balance shown on Interim Balance sheet) 7

Monthly Payment

Collateral Security

$

Reason For Loan