SBA Form 2234 B Supplemental Information For Premier Certified Lender Pr

OMB APPROVAL NO.: 3245-0346
EXPIRATION DATE: xx/xx/xxxx

SUPPLEMENTAL INFORMATION FOR
PREMIER CERTIFIED LENDER PROGRAM
(PCLP) PROCESSING

The PCLP Certified Development Company (CDC) completes this form as part of the application package for
Section 504 Loan and sends to: Sacramento Loan Processing Center, Small Business Administration, 6501
Sylvan Road, Suite 111, Citrus Heights, CA. 95610-5017 (or Fax to 916-735-0640).

Borrower Name:
Trade Name (dba):
Project Street:
Project Zip Code:
Borrower SSN #:
Employer ID #:
Project State:
Project City:

(if no trade name, enter “NA”)

Borrower Phone #:
(must include SSN # for principal of borrower)
(if available)
(2 letter abbreviation)

CDC Name:
CDC ID #:
Net Debenture Amount:

$

Borrower Contribution:

$

Exporter?

Yes

 New Business?

 No

Project County:
 Project located in Special Geographic Area

(in months)
Debenture Maturity:
Gross Debenture Amount: $

Closing Costs: $


If yes, export sales amount projected loan will support:

 Outstanding SBA Loan?

 Real Estate Collateral

$

Rural  or

Urban



NAICS Code:
 All Applicant’s production facilities are located in the U.S.?
No. of Employees:
No. of Jobs Created:
No. of Jobs Retained:
 CDC’s 504 loan portfolio meets or exceeds CDC’s required Job Opportunity Average
 Franchise?
Franchiser’s Name:
 Sole Proprietorship?
3rd Party Loan Amount:

 Partnership?
$

3rd Party Lender:

 Corporation?

 Other?

Lender ID #:

3rd Party Street:
3rd Party City:

State:

Zip Code:

 Special-Purpose Asset?

SBA Form 2234 (Part B) (02-16) Previous Editions Obsolete

Page 1 of 2
















B1 – Community or Area Development
C1 – Business District Revitalization
C2 – Expansion of Minority Business Development
C3 – Enhanced Economic Competition
C4 – Expansion of Exports
E1 – Reduce Energy Use by 10%
E3 – Renewable Energy Production

C5 - Restructuring Because of Federally Mandated Standards or Policies
C6 – Changes Necessitated by Federal Budget Cutbacks
C7 - Rural Development
C8 – Veteran-owned Businesses
C9 – Women-owned Businesses
E2 – Sustainable Building Design

Supplemental Information for PCLP Processing

Borrower Name:
Veteran Status: ** 1= Non-Veteran; 2= Other Vet.; 3=Service-Disabled Vet.; 4=Not Disclosed.
Gender: **
M= Male; F= Female; N= Not Disclosed
Race: **
1= American Indian/Alaska Native; 2= Asian; 3= Black/African-American; 4= Native Hawaiian/Pacific Islander
5= White; X= Not disclosed
Ethnicity: **
H= Hispanic/Latino; N= Not Hispanic/Latino; Y=Not Disclosed
Owner #
% Owned
Veteran Code
Gender Code
Race Ethnicity Please reference the above codes to complete this
table for each 20% or greater owners of the
business. More than one race code may be selected.
**Collected for statistical purposes only, disclosure
is voluntary and has no bearing on credit decision.

Use of Loan Proceeds
Purchase Land
Purchase Land and Improvements
Purchase Improvements
Construct a Building
Add an Addition to a Building
Make Renovation to a Building
Make Leasehold Improvements to a Building
Purchase/Install Equipment
Purchase/Install Fixtures
Pay Outstanding Debt

Amount
$
$
$
$
$
$
$
$
$
$

Other Expenses (eligible business expenses, $
construction contingency, interest on interim
financing, etc.)
Professional Fees
$
Total $
The estimated burden for completing this form is 25 minutes. You will not be required to respond to any collection of information unless it displays a
currently valid OMB Control Number. Comments on the burden should be sent to U. S. Small Business Administration (SBA), Chief, AIB, 409 3rd Street,
SW, Washington, DC 20416 and Desk Officer for SBA, Office of Management and Budget, New Executive Office Building, Room 10202, Washington, DC
20503. OMB Control Number 3245-0346. PLEASE DO NOT SEND FORMS TO OMB.

SBA Form 2234 (Part B) (09-16) Previous Editions Obsolete

Page 2 of 2