Sba Form 1244 - U.s. Small Business Administration Application For Section 504 Loans Page 10
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13Immigration and Nationality Act (8 U.S.C. 1101, et seq., as amended)
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 Citizenship and Immigration Services pursuant to the Immigration Reform and Control Act of 1986 (Pub. L. 99-
603). 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
or 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 as amended by E.O. 12689, 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 504 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.
Applicant Notifications
The Applicants, its proprietors, partners, officers or stockholders owning 20% or more of the Applicant
have/
have not
been involved in bankruptcy or insolvency proceedings. This question covers not only the Applicant, but also the personal bankruptcy or
insolvency proceedings of proprietors, partners, officers or stockholders owning 20% or more of the Applicant. You must attach copies
of the proceedings, if any.
The Applicant, its proprietors, partners, officers or stockholders owning 20% of more the Applicant
are/
are not
involved in any pending lawsuits. This question covers not only the Applicant, but also proprietors, partners, officers or
stockholders owning 20% or more of the Applicant in their personal capacities.
Applicant's Acknowledgment
My signature acknowledges receipt of these Statements Required by Laws and Executive Orders, that I have read it and that I have a copy for
my files. My signature represents my agreement to comply with the requirements SBA makes in connection with the approval of my loan
request and to comply, whenever applicable, with the limitations contained in these Statements.
Certification as to Application Accuracy – Criminal Penalties for False Statements
The undersigned certifies that all information provided to the CDC, and that all information in, and submitted with this application, including
all exhibits is true and complete to the best of his or her knowledge. Applicant acknowledges that the application and exhibits are submitted
to the CDC and to SBA so that the CDC and SBA can decide whether to approve this application. Any future submissions of information to
the CDC must be accompanied by a certification as to the accuracy of that information.
The undersigned acknowledges that whoever makes any false statement or report, or willfully overvalues any land property or security for the
purpose of influencing in any way the action of the SBA under the Small Business Investment Act, as amended, may be punished by a fine of
not more than $1,000,000 or by imprisonment for up to 30 years, or both, pursuant to 18 U.S.C. 1014. The undersigned further acknowledges
that, in connection with a 504 loan, submission of any false statement to the CDC or SBA or submission of any record to the CDC or SBA
omitting material information can result in civil money penalties and additional monetary liability up to three times the amount of damages
which the Government sustains because of the false statement under the False Claims Act, 31 U.S.C. 3729.
SBA Form 1244 (09-16) Previous editions obsolete
Page 10 of 13
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