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Paycheck Protection Program Loan Forgiveness Application ...

Paycheck Protection Program OMB Control No. 3245-0407. PPP Loan Forgiveness Application Form 3508EZ Expiration date: 12/31/2023. Business Legal Name ( Borrower ) DBA or Tradename, if applicable Business Address Business TIN (EIN, SSN) Business Phone ( ) - Primary Contact E-mail Address SBA PPP Loan Number: _____ Lender PPP Loan Number: _____. PPP Loan Amount: _____ PPP Loan Disbursement Date: _____. Employees at Time of Loan Application : _____ Employees at Time of Forgiveness Application : _____. EIDL Advance Amount: _____ EIDL Application Number: _____. Payroll Schedule: The frequency with which payroll is paid to employees is: Weekly Biweekly (every other week) Twice a month Monthly Other _____. Covered Period: _____ to _____. Alternative Payroll Covered Period, if applicable: _____ to _____. If Borrower (together with affiliates, if applicable) received PPP loans in excess of $2 million, check here.

the IRS and/or state tax or workforce agency. I also understand, acknowledge, and agree that the Lender can share the tax information with SBA’s authorized representatives, including authorized representatives of the SBA Office of Inspector General, for the purpose of ensuring compliance with PPP requirements and all SBA reviews. _____

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