Sba Form 1919 - Borrower Information - Applicant Business Information Page 7

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SBA 7(a) Borrower Information Form

OMB Control No.: 3245-0348

Statements Required by Law and Executive Order

Expiration Date: 07/31/2020

Civil Rights Legislation (13 C.F.R. 112, 113, 117) -- All businesses receiving SBA financial assistance must agree not to discriminate in any

business practice, including employment practices and services to the public on the basis of categories cited in 13 C.F.R., Parts 112, 113, and 117

of SBA Regulations. This includes making their goods and services available to handicapped clients or customers. All business borrowers will be

required to display the "Equal Employment Opportunity Poster" prescribed by SBA.

Equal Credit Opportunity Act (15 U.S.C. 1691) -- The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against

credit applicants on the basis of race, color, religion, national origin, sex, marital status or age (provided the applicant has the capacity to enter into a

binding contract); because all or part of the applicant's income derives from any public assistance program, or because the applicant has in good

faith exercised any right under the Consumer Credit Protection Act.

Executive Order 11738 -- Environmental Protection (38 F.R. 251621) -- The Executive Order charges SBA with administering its loan programs

in a manner that will result in effective enforcement of the Clean Air Act, the Federal Water Pollution Act and other environment protection

legislation.

Debt Collection Act of 1982, Deficit Reduction Act of 1984 (31 U.S.C. 3701 et seq. and other titles) -- These laws require SBA to collect

aggressively any loan payments which become delinquent. SBA must obtain your taxpayer identification number when you apply for a loan. If you

receive a loan, and do not make payments as they come due, SBA may take one or more of the following actions: (1) report the status of your

loan(s) to credit bureaus, (2) hire a collection agency to collect your loan, (3) offset your income tax refund or other amounts due to you from the

Federal Government, (4) suspend or debar you or your company from doing business with the Federal Government, (5) refer your loan to the

Department of Justice or other attorneys for litigation, or (6) foreclose on collateral or take other action permitted in the loan instruments.

Immigration Reform and Control Act of 1986 (Pub. L. 99-603) -- If you are an alien who was in this country illegally since before January 1,

1982, you may have been granted lawful temporary resident status by the United States Immigration and Naturalization Service pursuant to the

Immigration Reform and Control Act of 1986. For five years from the date you are granted such status, you are not eligible for financial assistance

from the SBA in the form of a loan guaranty under Section 7(a) of the Small Business Act unless you are disabled or a Cuban or Haitian entrant.

When you sign this document, you are making the certification that the Immigration Reform and Control Act of 1986 does not apply to you, or if it

does apply, more than five years have elapsed since you have been granted lawful temporary resident status pursuant to such 1986 legislation.

Lead-Based Paint Poisoning Prevention Act (42 U.S.C. 4821 et seq.) -- Borrowers using SBA funds for the construction or rehabilitation of a

residential structure are prohibited from using lead-based paint (as defined in SBA regulations) on all interior surfaces, whether accessible or not,

and exterior surfaces, such as stairs, decks, porches, railings, windows and doors, which are readily accessible to children under 7 years of age. A

"residential structure" is any home, apartment, hotel, motel, orphanage, boarding school, dormitory, day care center, extended care facility, college

or other school housing, hospital, group practice or community facility and all other residential or institutional structures where persons reside.

Executive Order 12549, Debarment and Suspension (2 CFR 180, adopted by reference in 2 CFR Part 2700 (SBA Debarment Regulations))

-- By submission of this loan application, you certify and acknowledge that neither you nor any Principals have within the past three years been: (a)

debarred, suspended, declared ineligible from participating in, or voluntarily excluded from participation in a transaction by any Federal department

or agency; (b) formally proposed for debarment, with a final determination still pending; (c) indicted, convicted, or had a civil judgment rendered

against you for any of the offenses listed in the Regulations; or (d) delinquent on any amounts due and owing to the U.S. Government or its agencies

or instrumentalities as of the date of execution of this certification.

If you are unable to certify and acknowledge (a) through (d), you must obtain and attach a written statement of exception from SBA permitting

participation in this loan. You further certify that you have not and will not knowingly enter into any agreement in connection with the goods

and/or services purchased with the proceeds of this loan with any individual or entity that has been debarred, suspended, declared ineligible from

participating in, or voluntarily excluded from participation in a Transaction. All capitalized terms have the meanings set forth in 2 C.F.R. Part 180.

NOTE: According to the Paperwork Reduction Act, you are not required to respond to this collection of information unless it displays a currently

valid OMB Control Number. The estimated burden for completing this form, including time for reviewing instructions, gathering data needed, and

completing and reviewing the form is 8 minutes per response. Comments or questions on the burden estimates should be sent to U.S. Small

Business Administration, Director, Records Management Division, 409 3rd St., SW, Washington DC 20416, and/or SBA Desk Officer, Office of

Management and Budget, New Executive Office Building, Rm. 10202, Washington DC 20503.

PLEASE DO NOT SEND FORMS TO THESE ADDRESSES.

SBA Form 1919 (05/17)