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BORROWER INFORMATION FORM

SBA 7(a) BORROWER INFORMATION Form OMB Control No.: 3245-0348 For use with all 7(a) Programs Expiration Date: 07/31/2020 SBA Form 1919 (01/18) 1 Purpose of this form: The purpose of this f orm is to collect INFORMATION about the Small Business Applicant ( Applicant ) and its p rincipals, the loan request, indebtedness, INFORMATION about current or previous government financing, and certain other topics. The INFORMATION also facilitates background checks as authorized by section 7(a)(1)(B) of the Small Business Act, 15 636(a)(1)(B).

Small Business Applicant Ownership. List all proprietors, partners, officers, directors, and holders of outstanding stock. 100% of ownership must be reflected. Attach a separate sheet if necessary. Based on this form’s instructions not all owners will need to complete the Principal Information section of this form.

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