Sba Form 1244 - Application For Section 504 Loans Page 7
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13XIX. ALL QUESTIONS MUST BE ANSWERED BY THE FOLLOWING INDIVIDUALS AND ARE SUBJECT TO VERIFICATION BY SBA:
(All parties listed below are considered “Associates” of the small business applicant.)
• For a sole proprietorship, the sole proprietor;
• For a corporation, all owners of 20% or more of the corporation
and each officer and director;
• For a partnership, all general partners and all limited partners
owning 20% or more of the equity of the firm, or any partner
• For limited liability companies (LLCs), all members owning 20%
that is involved in management of the applicant business;
or more of the company, each officer, director, and managing
member; and
• Any person hired by the business to manage day-to-day operations.
(If more than one person must complete this section, this page may be copied, completed, and attached to this form.)
1. Are you presently subject to an indictment, criminal information, arraignment, or
No
other means by which formal criminal charges are brought in any jurisdiction?
Initials:____________
Yes
No
2. Have you been arrested in the past six months for any criminal offense?
Initials:____________
Yes
3. For any criminal offense (other than a minor vehicle violation) have you ever:
1) been convicted; 2) plead guilty; 3) plead nolo contendere; 4) been placed on
pre-trial diversion; or 5) been placed on any form of parole or probation
No
(including probation before judgment)?
Yes
Initials:____________
4. Has an application for the loan you are applying for now ever been submitted to
SBA or to a Certified Development Company or Lender in connection with any
No
SBA program?
Yes
5. Are you presently debarred, suspended, proposed for debarment, declared ineligible,
or voluntarily excluded from participation in this transaction by any Federal
No
department or agency?
Yes
6. If you are at least a 50% or more owner of the applicant business, are you more
than 60 days delinquent on any obligation to pay child support arising under an
administrative order, court order, repayment agreement between the holder and a
custodial parent, or repayment agreement between the holder and a state agency
No
providing child support enforcement services?
Yes
N/A
No
7. Are you a U.S. citizen?
Yes
Initials:____________
No
If “No,” are you a Lawful Permanent Resident alien?
Yes
Initials:____________
If “Yes,” provide Alien Registration Number: _______________
If “No,” country of citizenship:_________________________
Signature:
Association to Applicant:
____________________________________
____________________________
(See list above)
Print Name:
__________________________________
• If “YES” to Question 1, the loan request is ineligible for SBA assistance.
• If “YES” to Question 2 or 3, you must complete and submit to the CDC SBA Form 912. The CDC will determine
whether the completed Form 912 must be submitted to SBA for a background check and a character
determination in accordance with SBA Loan Program Requirements (as defined in 13 CFR § 120.10).
• If “YES” to Question 3 and you are currently on parole or probation (including probation before judgment), the
loan request is ineligible for SBA assistance.
• If “YES” to Questions 4, 5 or 6, the application may not be approved by a PCLP CDC under its delegated
authority. The application must be submitted to the SLPC for processing and approval.
SBA Form 1244 (09-16) Previous editions obsolete
Page 7 of 13
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