SBA Form 413 "Personal Financial Statement"

What Is SBA Form 413?

This is a legal form that was released by the U.S. Small Business Administration on May 1, 2021 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2021;
  • The latest available edition released by the U.S. Small Business Administration;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of SBA Form 413 by clicking the link below or browse more documents and templates provided by the U.S. Small Business Administration.

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OMB APPROVAL NO.: 3245-0188
EXPIRATION DATE: 05/31/2024
PERSONAL FINANCIAL STATEMENT
U.S. SMALL BUSINESS ADMINISTRATION
The purpose of this form is to collect information about the Business Applicant and its owners’ financial condition. SBA uses the
information required by this Form 413 as one of a number of data sources in analyzing the repayment ability and creditworthiness of an applicant for
an SBA loan or, with respect to a surety bond, to assist in recovery in the event that the contractor defaults on the contract. SBA also uses the
information to assess whether an individual meets the economic disadvantage threshold for the Women-Owned Small Business (WOSB) Program
and the 8(a) Business Development (BD) Program. Submission of this information is required as part of your application for assistance. Failure to
provide the information would impact the agency’s decision on your application.
To complete this form
1)
Check all that apply.
2)
Complete the form in its entirety (attached a separate sheet, if necessary)
3)
Review the applicable certifications and sign (spousal signature, if required)
7(a) loan / 504 loan / Surety Bonds
Complete this form for: (1) each proprietor; (2) general partner; (3) managing member of a limited liability company (LLC); (4) each owner of 20% or more of the equity
of the Applicant; and (5) any person providing a guaranty on the loan (including the assets and liabilities of the owner’s spouse and any minor children).
Return completed form to:
For 7(a) loans: the Lender processing the application for SBA guaranty
For 504 loans: the Certified Development Company (CDC) processing the application for SBA guaranty
For Surety Bonds: the Surety Company or Agent processing the application for surety bond guarantee
Disaster Business Loan Application (Excluding Sole Proprietorships)
Complete this form for: (1) each applicant; (2) each general partner; (3) each managing member of a limited liability company (LLC); (4) each owner of 20% or more of
the equity of the Applicant business; and (5) any person providing an unlimited guaranty on the loan.
Return completed form to: Disaster Processing and Disbursement Center at 14925 Kingsport Road, Fort Worth, TX 76155-2243 or FAX to 1-202-481-1505 or
disasterloans@sba.gov
Women Owned Small Business (WOSB) Federal Contracting Program
This form must be completed by each individual claiming economic disadvantage in connection with the SBA’s Women-Owned Small Business (WOSB) Federal
Contracting Program. A separate form must be completed by the individual’s spouse, unless the individual and the spouse are legally separated. Use attachments if
necessary. Each attachment must be identified as a part of this statement and signed. In addition, each individual claiming economic disadvantage must update the
form as changes arise, but at least annually, to ensure the information is current, accurate and complete.
SBA’s regulations state that to be considered economically disadvantaged for purposes of the WOSB Program, a woman must have an adjusted gross income
averaged over the three prior fiscal years of $350,000 or less; less than $6 million in the fair market value of all her assets (to include her primary residence and value
of the business concern); and less than $750,000 in personal net worth (excluding equity interest in her personal residence and ownership interest in the business,
and funds invested in a retirement account that are unavailable until retirement age). 13 C.F.R. §127.203. The information contained in this form must be submitted
and certified through beta.certify.sba.gov
8(a) Business Development Program
8(a) applicants must show that 51% of the firm is owned by one or more individuals determined by the SBA to be socially and economically disadvantaged. The
information contained in this form must be submitted by each socially and economically disadvantaged individual using their one time 8(a) eligibility to qualify this firm
for 8(a) certification. If married, the spouse must complete a separate SBA Form 413, except when the individual and the spouse are legally separated. If separated,
provide copy of separation document.
SBA’s regulations state that to be considered economically disadvantaged for purposes of the 8(a) Business Development Program, an individual must have an
adjusted gross income averaged over the three prior fiscal years of $350,000 or less; less than $6 million in the fair market value of all assets (to include primary
residence and value of the business concern); and less than $750,000 in personal net worth (excluding equity interest in the personal residence and ownership
interest in the business, and funds invested in a retirement account that are unavailable until retirement age). 13 C.F.R. §124.104.
Note: Please complete this form with Personal Information not Business Information and divide all jointly owned assets and liabilities, as appropriate with spouse or
others. The information contained in this form must be submitted and certified through certify.sba.gov. For additional information go to:
http://www.sba.gov/8abd
SBA Form 413 (05-21) Previous Editions Obsolete
Page 1
OMB APPROVAL NO.: 3245-0188
EXPIRATION DATE: 05/31/2024
PERSONAL FINANCIAL STATEMENT
U.S. SMALL BUSINESS ADMINISTRATION
The purpose of this form is to collect information about the Business Applicant and its owners’ financial condition. SBA uses the
information required by this Form 413 as one of a number of data sources in analyzing the repayment ability and creditworthiness of an applicant for
an SBA loan or, with respect to a surety bond, to assist in recovery in the event that the contractor defaults on the contract. SBA also uses the
information to assess whether an individual meets the economic disadvantage threshold for the Women-Owned Small Business (WOSB) Program
and the 8(a) Business Development (BD) Program. Submission of this information is required as part of your application for assistance. Failure to
provide the information would impact the agency’s decision on your application.
To complete this form
1)
Check all that apply.
2)
Complete the form in its entirety (attached a separate sheet, if necessary)
3)
Review the applicable certifications and sign (spousal signature, if required)
7(a) loan / 504 loan / Surety Bonds
Complete this form for: (1) each proprietor; (2) general partner; (3) managing member of a limited liability company (LLC); (4) each owner of 20% or more of the equity
of the Applicant; and (5) any person providing a guaranty on the loan (including the assets and liabilities of the owner’s spouse and any minor children).
Return completed form to:
For 7(a) loans: the Lender processing the application for SBA guaranty
For 504 loans: the Certified Development Company (CDC) processing the application for SBA guaranty
For Surety Bonds: the Surety Company or Agent processing the application for surety bond guarantee
Disaster Business Loan Application (Excluding Sole Proprietorships)
Complete this form for: (1) each applicant; (2) each general partner; (3) each managing member of a limited liability company (LLC); (4) each owner of 20% or more of
the equity of the Applicant business; and (5) any person providing an unlimited guaranty on the loan.
Return completed form to: Disaster Processing and Disbursement Center at 14925 Kingsport Road, Fort Worth, TX 76155-2243 or FAX to 1-202-481-1505 or
disasterloans@sba.gov
Women Owned Small Business (WOSB) Federal Contracting Program
This form must be completed by each individual claiming economic disadvantage in connection with the SBA’s Women-Owned Small Business (WOSB) Federal
Contracting Program. A separate form must be completed by the individual’s spouse, unless the individual and the spouse are legally separated. Use attachments if
necessary. Each attachment must be identified as a part of this statement and signed. In addition, each individual claiming economic disadvantage must update the
form as changes arise, but at least annually, to ensure the information is current, accurate and complete.
SBA’s regulations state that to be considered economically disadvantaged for purposes of the WOSB Program, a woman must have an adjusted gross income
averaged over the three prior fiscal years of $350,000 or less; less than $6 million in the fair market value of all her assets (to include her primary residence and value
of the business concern); and less than $750,000 in personal net worth (excluding equity interest in her personal residence and ownership interest in the business,
and funds invested in a retirement account that are unavailable until retirement age). 13 C.F.R. §127.203. The information contained in this form must be submitted
and certified through beta.certify.sba.gov
8(a) Business Development Program
8(a) applicants must show that 51% of the firm is owned by one or more individuals determined by the SBA to be socially and economically disadvantaged. The
information contained in this form must be submitted by each socially and economically disadvantaged individual using their one time 8(a) eligibility to qualify this firm
for 8(a) certification. If married, the spouse must complete a separate SBA Form 413, except when the individual and the spouse are legally separated. If separated,
provide copy of separation document.
SBA’s regulations state that to be considered economically disadvantaged for purposes of the 8(a) Business Development Program, an individual must have an
adjusted gross income averaged over the three prior fiscal years of $350,000 or less; less than $6 million in the fair market value of all assets (to include primary
residence and value of the business concern); and less than $750,000 in personal net worth (excluding equity interest in the personal residence and ownership
interest in the business, and funds invested in a retirement account that are unavailable until retirement age). 13 C.F.R. §124.104.
Note: Please complete this form with Personal Information not Business Information and divide all jointly owned assets and liabilities, as appropriate with spouse or
others. The information contained in this form must be submitted and certified through certify.sba.gov. For additional information go to:
http://www.sba.gov/8abd
SBA Form 413 (05-21) Previous Editions Obsolete
Page 1
Name
Business Phone
(xxx-xxx-xxxx)
Home Address
Home Phone
(xxx-xxx-xxxx)
City, State, & Zip Code
Business Name of Applicant/Borrower
Business Address
(if different than home address)
Business Type: ___ Corporation ___ S-Corp. ___ LLC ___ Partnership ___ Sole Proprietor
(does not apply to ODA applicant)
This information is current as of [month/day/year]
(within 90 days of submission for 7(a)/504/SBG/ODA/WOSB or within 30 days of submission for 8(a) BD)
WOSB applicant only, Married ___ Yes ___ No
ASSETS
LIABILITIES
(Omit Cents)
(Omit Cents)
Cash on Hand & in banks………………………… ________________
Accounts Payable…………………………… ______________
Savings Accounts…………………………………. ________________
Notes Payable to Banks and Others……… ______________
IRA or Other Retirement Account……………….. ________________
(Describe in Section 2)
(Describe in Section 5)
Installment Account (Auto)………………….. ______________
Accounts & Notes Receivable……………………. ________________
Mo. Payments
___________
(Describe in Section 5)
Installment Account (Other)……………….... ______________
Life Insurance – Cash Surrender Value Only …… ________________
Mo. Payments
___________
(Describe in Section 8)
Loan(s) Against Life Insurance……………... ______________
Stocks and Bonds………………………………….. ________________
Mortgages on Real Estate…………………... ______________
(Describe in Section 3)
(Describe in Section 4)
Real Estate………………………………………….. ________________
Unpaid Taxes…………………………………. _____________
(Describe in Section 4)
(Describe in Section 6)
Automobiles………………………………………… ________________
Other Liabilities……………………………….. _____________
(Describe in Section 5, and include
(Describe in Section 7)
Year/Make/Model)
Total Liabilities……………………………….... _____________
$ 0
Other Personal Property…………………………… ________________
Net Worth………………………………………. _____________
(Describe in Section 5)
Total
_____________
Other Assets…………………………………….…. _______________
$ 0
(Describe in Section 5)
Must equal total in assets column.
Total
________________
$ 0
Section 1.
Source of Income.
Contingent Liabilities
Salary…………………………………………………. ________________
As Endorser or Co-Maker……………………. _____________
Net Investment Income……………………………... ________________
Legal Claims & Judgments………………….. _____________
Real Estate Income…………………………………. ________________
Provision for Federal Income Tax…………..._____________
Other Income (Describe below)….………………... ________________
Other Special Debt……………………………. _____________
Description of Other Income in Section 1 (
Alimony or child support payments should not be disclosed in “Other Income” unless it is desired to have such
payments counted toward total income)
SBA Form 413 (05-21) Previous Editions Obsolete
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Section 2. Notes Payable to Banks and Others.
(Use attachments if necessary. Each attachment must be identified as part of this statement and signed.)
Names and Addresses of
Original
Current
Payment
Frequency
How Secured or Endorsed
Noteholder(s)
Balance
Balance
Amount
(monthly, etc.)
Type of Collateral
Section 3. Stocks and Bonds.
(Use attachments if necessary. Each attachment must be identified as part of this statement and signed.)
Market Value
Date of
Number of Shares
Name of Securities
Cost
Total Value
Quotation/Exchange
Quotation/Exchange
Section 4. Real Estate Owned.
(List each parcel separately. Use attachment if necessary. Each attachment must be identified as a part of this statement
and signed.)
Property A
Property B
Property C
Type of Real Estate (e.g.
Primary Residence, Other
Residence, Rental Property,
Land, etc.)
Address
Date Purchased
Original Cost
Present Market Value
Name & Address of
Mortgage Holder
Mortgage Account Number
Mortgage Balance
Amount of Payment per
Month/Year
Status of Mortgage
Section 5. Other Personal Property and Other Assets. (Describe, and, if any is pledged as security, state name and address of lien
holder, amount of lien, terms of payment and, if delinquent, describe delinquency.)
SBA Form 413 (05-21) Previous Editions Obsolete
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Section 6. Unpaid Taxes. (Describe in detail as to type, to whom payable, when due, amount, and to what property, if any, a tax
lien attaches.)
Section 7. Other Liabilities. (Describe in detail.)
Section 8. Life Insurance Held. (Give face amount and cash surrender value of policies – name of insurance company and
Beneficiaries.)
I authorize the SBA/Lender/Surety Company to make inquiries as necessary to verify the accuracy of the statements made and to
determine my creditworthiness.
CERTIFICATION: (to be completed by each person submitting the information requested on this form and the spouse of any 20% or
more owner when spousal assets are included)
By signing this form, I certify under penalty of criminal prosecution that all information on this form and any additional supporting
information submitted with this form is true and complete to the best of my knowledge. I understand that SBA or its participating
Lenders or Certified Development Companies or Surety Companies will rely on this information when making decisions regarding an
application for a loan, surety bond, or participation in the WOSB or 8(a) BD program. I further certify that I have read the attached
statements required by law and executive order.-
Signature ________________________________________
Date
____________________
Print Name _______________________________________
Social Security No.
____________________
Signature ________________________________________
Date
____________________
Print Name _______________________________________
Social Security No.
____________________
SBA Form 413 (05-21) Previous Editions Obsolete
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NOTICE TO 7(a) LOAN, 504 LOAN AND SURETY BOND APPLICANTS: CRIMINAL PENALITIES AND ADMINISTRATIVE
REMEDIES FOR FALSE STATEMENTS:
Knowingly making a false statement on this form is a violation of Federal law and could result in criminal prosecution, significant
civil penalties, and a denial of your loan or surety bond application. A false statement is punishable under 18 U.S.C. §§ 1001
and 3571 by imprisonment of not more than five years and/or a fine of up to $250,000; under 15 U.S.C. § 645 by imprisonment
of not more than two years and/or a fine of not more than $5,000; and, if submitted to a Federally-insured institution, a false
statement is punishable under 18 U.S.C. § 1014 by imprisonment of not more than thirty years and/or a fine of not more than
$1,000,000. Additionally, false statements can lead to treble damages and civil penalties under the False Claims Act, 31
U.S.C. § 3729, and other administrative remedies including suspension and debarment.
NOTICE TO DISASTER BUSINESS LOAN APPLICANTS: CRIMINAL PENALTIES AND ADMINISTRATIVE REMEDIES FOR
FALSE STATEMENTS:
Whoever wrongfully misapplies the proceeds of an SBA disaster loan shall be civilly liable to the Administrator in an amount equal to
one-and-one half times the original principal amount of the loan under 15 U.S.C. § 636(b). In addition, any false statement or
misrepresentation to SBA may result in criminal, civil or administrative sanctions including, but not limited to: 1) fines and
imprisonment, or both, under 15 U.S.C. § 645, 18 U.S.C. § 1001, 18 U.S.C. § 1014, 18 U.S.C. § 1040, 18 U.S.C. § 3571, and any
other applicable laws; 2) treble damages and civil penalties under the False Claims Act, 31 U.S.C. § 3729; 3) double damages and
civil penalties under the Program Fraud Civil Remedies Act, 31 U.S.C. § 3802; and 4) suspension and/or debarment from all Federal
procurement and non-procurement transactions. Statutory fines may increase if amended by the Federal Civil Penalties Inflation
Adjustment Act Improvements Act of 2015.
NOTICE TO APPLICANTS OR PARTICIPANTS IN THE WOSB FEDERAL CONTRACTING PROGRAM: CRIMINAL PENALITIES
AND ADMINISTRATIVE REMEDIES FOR FALSE STATEMENTS:
Any person who misrepresents a business concern’s status as a WOSB or EDWOSB, or makes any other false statement in order to
influence the WOSB Program eligibility determination or other review process in any way (e.g., protest), shall be: (1) subject to fines
and imprisonment of up to 5 years, or both, as stated in Title 18 U.S.C. § 1001; (2) subject to fines of up to $500,000 or imprisonment
of up to 10 years, or both, as stated in Title 15 U.S.C. § 645; (3) subject to civil and administrative remedies, including suspension and
debarment; and (4) ineligible for participation in programs conducted under the authority of the Small Business Act.
NOTICE TO APPLICANTS OR PARTICIPANTS IN THE 8(a) BUSINESS DEVELOPMENT PROGRAM: CRIMINAL PENALTIES
AND ADMINISTRATIVE REMEDIES FOR FALSE STATEMENTS:
Any person who misrepresents a business concern’s status as an 8(a) BD Program participant or SDB concern, or makes any other
false statement in order to influence the 8(a) certification or other review process in any way(e.g., annual review, eligibility review),
shall be: (1) subject to fines and imprisonment of up to 5 years, or both, as stated in Title 18 U.S.C. § 1001; (2) subject to fines of up
to $500,000 or imprisonment of up to 10 years, or both, as stated in Title 15 U.S.C. § 645; (3) subject to treble damages and civil
penalties under the False Claims Act, 31 U.S.C. § 3729; (4) subject to administrative remedies, including suspension and debarment;
and (5) ineligible for participation in programs conducted under the authority of the Small Business Act.
According to the Paperwork Reduction Act, you are not required to respond to this request for information unless it displays a valid OMB
PLEASE NOTE:
Control Number. The estimated average burden hours for the completion of this form is 1.5 hour per response. If you have questions or
comments concerning this estimate or any other aspect of this information collection, please contact: Director, Records Management
Division, Small Business Administration, 409 Third Street SW, Washington, D.C. 20416, and SBA Desk Officer, Office of Management and
Budget, New Executive Office Building, Room 10202, Washington, D.C. 20503. PLEASE DO NOT SEND COMPLETED FORMS TO OMB.
SBA Form 413 (05-21) Previous Editions Obsolete
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