Shirley Campbell

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Paycheck Protection Program Application checklist
PLEASE SEND ONE EMAIL (ZIP THE FILE SO IT IS NOT TOO LARGE 25MB MAX SIZE)
Complete Paycheck Protection Program Application Form and Addendums as applicable
o Applicant Ownership Detail with Certification
 Sign Certification that all employees live within the United
States. If any do not, provide a detailed list with corresponding salaries of all employees outside the United States
o Addendum A ­ Affiliates o Addendum B ­ Economic Injury Disaster Loan (EIDL)
Company Entity Documents (if not on file with Bank)
Driver License or State Issued ID Card for Beneficial Ownership Identification
Payroll Expense verification documents to include:
o IRS Form 940/ 941/944, 1099, Detailed Payroll Report for 2019
or Employee paystubs to support average monthly payroll for 2019
o Payroll Detail Reports or January & February 2020 o Breakdown of payroll benefits (vacation, allowance for
dismissal, group healthcare benefits, retirement benefits, etc.)
o 1099s (if Independent Contractor)
Complete Loan Estimator
Attach most recent Mortgage Statement or Rent Statement (Lease)
Most recent Utility Bills for Expenses claimed in Section II of loan estimator
*** All information is fluid and subject to change pending guidance from SBA ***

Applicant Ownership

List all owners of Applicant with greater than 20% ownership stakes or until 90% of applicant business ownership is identified.
Please Note: The bank is asking for this information because we do not want applications to be delayed during our SBA data input process. Identifying 90% of business ownership has been required by SBA to receive approval numbers in the past. This requirement may change after SBA releases guidance to banks. Again, we are being proactive with this request to avoid possible delays. (add separate sheet if necessary)
DATE: _____________________

Owner Name

Title Ownership TIN (EIN, SSN) %

Address

I Certify that all employees live within the United States : ________________________________________ Signature
If employees do not live within the United States provide detailed list with corresponding salaries

Addendum A Question 3 on Paycheck Protection Program Application Form
Complete this addendum if number 3 was answered yes on application form -
Affiliation ­ Concerns and entities are affiliates of each other when one controls or has the power to control the other, or a third party (or parties) controls or has power to control both. For example, affiliation may arise through ownership, common management (including through a management agreement), or when there is an identity of interest between close relatives with identical, or substantially identical, business interests. The complete definition of "affiliation" is found at 13CFR § 121.301(f).
Affiliate Business Information If yes, please provide the following information for each entity:
Affiliate Company Name: ______________________________________________ NAICS Code for Affiliate: ___________ Number of Employees: _____________
Affiliate Company Name: ______________________________________________ NAICS Code for Affiliate: ___________ Number of Employees: _____________
Affiliate Company Name: ______________________________________________ NAICS Code for Affiliate: ___________ Number of Employees: _____________
Affiliate Company Name: ______________________________________________ NAICS Code for Affiliate: ___________ Number of Employees: _____________
Affiliate Company Name: ______________________________________________ NAICS Code for Affiliate: ___________ Number of Employees: _____________
Affiliate Company Name: ______________________________________________ NAICS Code for Affiliate: ___________ Number of Employees: _____________

Addendum B Question 4 on Paycheck Protection Program Application Form
Complete this addendum if number 4 was answered yes on application form -
SBA Economic Injury Disaster Loan - EIDL
Between January 31, 2020 and April 3, 2020 provided the following information:
Loan Date: __________________ Loan Amount Approved: ________________ Current outstanding Balance: __________________________ Details on uses of proceeds: ______________________________________________
_____________________________________________________________________
_____________________________________________________________________
Loan Date: __________________ Loan Amount Approved: ________________ Current outstanding Balance: __________________________ Details on uses of proceeds: ______________________________________________
_____________________________________________________________________
_____________________________________________________________________

BUSINESS ENTITIES IN TEXAS
CORPORATION: Borrower, Co-Borrower, Guarantor, or Pledgor
(ABC, Inc., a Texas corporation)
a. Articles of Organization including any and all amendments certified by the Secretary of States b. Certificate of Formation (will suffice if they do not have copies of their original filed Articles) c. Bylaws d. Certificate of Good Standing e. Assumed Name Certificate filed with the County Clerk, if using an assumed name (dba)
LIMITED PARTNERSHIP: Borrower, Co-Borrower, Guarantor, or Pledgor
(ABC, Inc., a Texas limited partnership)
a. Partnership Agreement including any and all amendments b. Certificate of Limited Partnership certified by the Secretary of State c. Certificate of Good Standing d. Assumed Name Certificate filed with the County Clerk, if using an assumed name (dba) e. General Partner, must meet due diligence requirements for specific entity type
LIMITED LIABILITY COMPANY: Borrower, Co-Borrower, Guarantor, or Pledgor
(ABC, Inc., a Texas limited liability company)
a. Articles/Certificate of Formation (will suffice if they do not have copies of their original filed Articles)
b. Regulations, Operating Agreement, Company Agreement or Joinder, if applicable (not required for sole member LLC)
c. Certificate of Good Standing d. Assumed Name Certificate filed with the County Clerk, if using an assumed name (dba) e. A Limited Liability is either ran by Managers or Members, but can also be assigned a title, if so
their title would be (Manager/President, Member/President or Managing Member/President) f. Manager/Member must meet due diligence requirements appropriate for specific entity type, if
its manager/member is not an individual
GENERAL PARTNER: Borrower, Co-Borrower, Guarantor, or Pledgor
(ABC, Inc., a Texas general partner)
a. Partnership Agreement is required for a Limited Partnership including any and all amendments (no written agreement for a general partnership)
b. Assumed Name Certificate filed with the County Clerk, if using an assumed name (dba) c. Not required to be registered with the Secretary of State
JOINT VENTURE: Borrower, Co-Borrower, Guarantor, or Pledgor
(ABC, Inc., a Texas joint venture)
a. Joint Venture Agreement, including any and all amendments b. Assumed Name Certificate filed with the County Clerk, if using an assumed name (dba)