Form SBA Form 2234 (B) SBA Form 2234 (B) Supplemental Information for PCLP Processing

OMB Approval No.: 3245-0346
Effective Date:
Expiration Date:

Supplemental Information for PCLP Processing

Borrower Name:

Trade Name (dba):

(if no trade name, enter “NA”)

Project Street:

Project Zip Code:

Borrower Phone #:

Borrower SSN #:

(must include SSN # for principal of borrower)

Employer ID #:

(if available)

Project State:

(2 letter abbreviation)

Project County:

Project City:

• Project located in Special Geographic Area

CDC Name:

CDC ID #:

Debenture Maturity:

(in months)

Debenture Amount:

$

Construction Amount:

$

New Construction?

Exporter?

Yes

No

$ If yes, export sales amount projected loan will support:

New Business?

Outstanding SBA Loan?

Real Estate Collateral?

Rural

or

Urban

NAICS Code:

All Applicant’s production facilities are located in the U.S.?

No. of Employees:

No. of Jobs Created:

No. of Jobs Retained:

• CDC’s 504 loan portfolio meets or exceeds CDC’s required Job Opportunity Average

Franchise?

Franchiser’s Name:

Sole Proprietorship?

Partnership?

Corporation?

Other?

3rd Party Loan Amount:

$

3rd Party Lender:

3rd Party Lender ID #:

(if available)

3rd Party Street:

3rd Party City:

State:

Zip Code:

• Special-Purpose Asset?

B1 – Community or Area Development	C5 - Restructuring Because of Federally Mandated Standards or Policies
C1 – Business District Revitalization	C6 – Changes Necessitated by Federal Budget Cutbacks
C2 – Expansion of Minority Business Development	C7 - Rural Development
C3 – Enhanced Economic Competition C4 – Expansion of Exports	C8 – Veteran-owned Businesses C9 – Women-owned Businesses

Veteran Status:**		1=Non-Veteran; 2=Veteran-Other; 3=Service-Disabled Veteran; 4=Not Disclosed.
Gender: **		M=Male; F=Female; N=Not Disclosed
Race: **		1=American Indian or Alaska Native; 2=Asian; 3=Black or African-American; 4=Native Hawaiian or Other Pacific Islander; 5=White; X=Not Disclosed
Ethnicity: **		H=Hispanic or Latino; N=Not Hispanic or Latino
Owner #	% Owned		Veteran Code	Gender	Race	Ethnicity	Please reference the above codes to complete this table for each 20% or greater owners of the business. More than one race code may be selected.** Collected for statistical purposes only, disclosure is voluntary and has no bearing on credit decision.

SBA Form 2234 (Part B)