SBA EIB-SBA Form 84-1 Joint Application for Export Working Capital Guarantee

SBA form EIB-SBA84-1 or the "Joint Application For Export Working Capital Guarantee" is a form issued by the U.S. Small Business Administration.

The form was last revised in January 1, 2017 and is available for digital filing. Download an up-to-date fillable SBA Form EIB-SBA84-1 in PDF-format down below or look it up on the U.S. Small Business Administration Forms website.

ADVERTISEMENT
OMB No.: 3048-003
Expiration Date: 03/31/2020
U.S. SMALL BUSINESS ADMINISTRATION
and
EXPORT-IMPORT BANK OF THE UNITED STATES
JOINT APPLICATION FOR EXPORT WORKING CAPITAL GUARANTEE
APPLICATION INSTRUCTIONS
PART A. PRINCIPAL PARTIES
1. Borrower/Exporter. Complete this section with information on the individual or corporate borrower. Provide the
primary North American Industrial Classification System (NAICS) number of the borrower, rather than the product being
exported.
2. Borrower’s Management. Complete this section for each proprietor, partner, officer, director or other individual
owning 20% or more of the borrower. 100% of ownership must be shown. The following are considered “Associates” of
the borrower: a. for a sole proprietorship, the sole proprietor; b. for a partnership, all general partners and all limited
partners owning 20% or more of the equity of the firm; c. for a corporation, all owners of 20% or more of the
corporation and each officer and director; d. for limited liability companies (LLCs), all members owning 20% or more of
the company, each officer, director, and managing member; d. any person hired by the business to manage day-to-day
operations. All Associates must be shown.
3. Borrower’s Affiliate(s). Provide information about all of the Borrower’s Affiliates. See 13 CFR 121.103, 13 CFR
121.107 and 13 CFR 121.301.
4. Personal and/or Corporate Guarantor(s). List all individuals and entities that will guarantee repayment of the loan.
The personal guarantee of the owner(s) is required in most cases.
5. Lender. Leave blank if you are applying for a Preliminary Commitment and a prospective lender has not been
identified.
PART B. INFORMATION ABOUT THE TRANSACTION
Provide type of loan requested, the loan amount, and term and answer all questions in Part B. (See also Checklist item 2
below.)
PART C. CERTIFICATIONS
This section must be signed by an authorized representative of the borrower, each guarantor, and, if this is a request for
a final commitment, the Lender. For SBA Applicants only—this section must be signed by each Associate of the
borrower (see above for definition) and each guarantor.
EIB-SBA Form 84-1, Revised 01/2017
1.
OMB No.: 3048-003
Expiration Date: 03/31/2020
U.S. SMALL BUSINESS ADMINISTRATION
and
EXPORT-IMPORT BANK OF THE UNITED STATES
JOINT APPLICATION FOR EXPORT WORKING CAPITAL GUARANTEE
APPLICATION INSTRUCTIONS
PART A. PRINCIPAL PARTIES
1. Borrower/Exporter. Complete this section with information on the individual or corporate borrower. Provide the
primary North American Industrial Classification System (NAICS) number of the borrower, rather than the product being
exported.
2. Borrower’s Management. Complete this section for each proprietor, partner, officer, director or other individual
owning 20% or more of the borrower. 100% of ownership must be shown. The following are considered “Associates” of
the borrower: a. for a sole proprietorship, the sole proprietor; b. for a partnership, all general partners and all limited
partners owning 20% or more of the equity of the firm; c. for a corporation, all owners of 20% or more of the
corporation and each officer and director; d. for limited liability companies (LLCs), all members owning 20% or more of
the company, each officer, director, and managing member; d. any person hired by the business to manage day-to-day
operations. All Associates must be shown.
3. Borrower’s Affiliate(s). Provide information about all of the Borrower’s Affiliates. See 13 CFR 121.103, 13 CFR
121.107 and 13 CFR 121.301.
4. Personal and/or Corporate Guarantor(s). List all individuals and entities that will guarantee repayment of the loan.
The personal guarantee of the owner(s) is required in most cases.
5. Lender. Leave blank if you are applying for a Preliminary Commitment and a prospective lender has not been
identified.
PART B. INFORMATION ABOUT THE TRANSACTION
Provide type of loan requested, the loan amount, and term and answer all questions in Part B. (See also Checklist item 2
below.)
PART C. CERTIFICATIONS
This section must be signed by an authorized representative of the borrower, each guarantor, and, if this is a request for
a final commitment, the Lender. For SBA Applicants only—this section must be signed by each Associate of the
borrower (see above for definition) and each guarantor.
EIB-SBA Form 84-1, Revised 01/2017
1.
OMB No.: 3048-003
Expiration Date: 03/31/2020
CHECKLIST OF INFORMATION TO BE ATTACHED
BACKGROUND
YES
N/A
1. Brief resume of the principals and key employees; history of business; copy of business plan, if available; identify
whether sole proprietorship, general partnership, limited liability company (LLC), corporation and/or subchapter-S
corporation.
2. Explanation of use of proceeds and benefits of the loan guarantee, including details of the underlying
transaction(s) for which the loan is needed, including country(s) where the buyers are located.
TRANSACTION
YES
N/A
3. Attach product literature. Ex-Im Bank applicants only: If applicable, attach description of items if they are
nuclear, military, environmental, on the U.S. Munitions Control List, or require an export license.
4. Copy of letter of credit and/or copy of buyer’s order/contract, if required.
5. Export credit insurance-related material (policy, application, buyer credit limit), if required.
6. Copy of export license, if required.
FINANCIAL INFORMATION
YES
N/A
7. Business financial statements (Balance Sheet, Income Statement, statement of Cash Flows) for the last three
years, if applicable, supported by the most recent Federal income tax return for the business. SBA applicants
only: Business financial statements and/or tax returns for the last three years, if applicable.
8. Current financial statement (interim) dated within 90 days (SBA Applicants only: 180 days) of the date of the
application filing.
9. Aging of accounts receivable and accounts payable, as of the same date as #8 above, if required.
10. All Affiliated Companies – Business Financial Statements (Balance Sheet, Income Statement, Aging of Accounts
Receivable and Accounts Payable) for the last completed fiscal year end, as well as current statements no older
than 90 days (SBA Applicants only: 180 days) from the date of application filing. In addition, submit signed
Federal income tax returns for the last fiscal year end or an extension form if not filed after the due date.
Important Requirement – Submit a combined or consolidated financial statement for the current period as
well as the last fiscal year end (combining all affiliated companies), eliminating any inter-company transactions
(sales, receivables, payables, etc.).
11. Signed joint personal financial statement(s) of each major shareholder(s)/partner(s), owner(s), of the
company (with 20% or greater ownership, including assets and liabilities of both spouses) and their most recent
Federal income tax return (not required for venture capital partners).
12. Estimate of monthly cash flow for the terms of the loan, highlighting the proposed export transaction.
13. Description of type and value of proposed collateral to support the loan (company assets/export product, i.e.,
inventory, accounts receivable, other).
14. Attach credit memorandum prepared by the Lender. SBA applicants only: Also attach D&B Report and
Personal Credit Reports on Principals and Guarantors.
15. Ex-Im Bank applicants only: Nonrefundable $500 application fee for a Preliminary Commitment or
nonrefundable $100 application fee for a Final Commitment, whichever is applicable, by check or money order
made out to the Ex-Im Bank.
16. SBA applicants only: Copy of IRS Form 4506-T (original to be submitted to IRS by the Lender).
YES
N/A
OTHER INFORMATION
17. SBA applicants only: If there is a “YES” response to Question e.2. or e.3. in Part C.2., submit a completed SBA
Form 912 with details furnished on a separate sheet, including dates, location, fines, sentences, whether
misdemeanor or felony, dates of parole/probation, unpaid fines or penalties, name(s) under which charged, and
any other pertinent information. NOTE: If there is a “YES” response to Question e.1. in Part C.2., the loan request
is ineligible for SBA assistance.
18. SBA applicants only: If the borrower used (or intends to use) a packager, broker, accountant, lawyer, etc. to
assist in (a) preparing the loan application or any related materials and/or (b) referring the loan to the lender, a
SBA Form 159 7(a) will need to be completed by the borrower and the lender and submitted.
19. SBA applicants only: If the lender is processing this loan under its PLP-EWCP delegated authority, lender must
submit SBA Form 1920.
EIB-SBA Form 84-1, Revised 01/2017
2.
OMB No.: 3048-003
Expiration Date: 03/31/2020
(SBA Use Only)
U.S. SMALL BUSINESS ADMINISTRATION
(Ex-Im Bank Use Only)
Date Received:
Date Received:
EXPORT-IMPORT BANK OF THE UNITED STATES
C.I.D. No.:
JOINT APPLICATION FOR
Intermediary:
EXPORT WORKING CAPITAL GUARANTEE
PART A. PRINCIPAL PARTIES
Please check the
New to Ex-Im Bank?
Yes
No
1. Borrower/Exporter
appropriate answer:
New to SBA?
Yes
No
Company Name
Dba/
Date Business
Established
Telephone No.
Fax No.
D&B No.
Federal ID No.
Name and Title of Contact Person
E-mail Address
Address (No P.O. Boxes)
County of Business
City
State
Zip+4
Gross Annual
No. of Full-Time
Primary North American Industrial
“Small Business Concern” as
Sales Last Year:
Employees:
Classification System (NAICS) No.:
described in SBA Guidelines:
Yes
No
*Is the Borrower a minority-
*A women-owned business?
*A Veteran-owned business?
owned business?
Yes
No
Yes
No
Yes
No
Not Disclosed
Not Disclosed
Not Disclosed
2. Borrower’s Management (Proprietors, partners, officers, directors and holders of all outstanding
stock or other ownership interests – 100% of ownership mush be shown. Include anyone who was a
principal within the last six months.) Attach separate sheet of paper if necessary.
* - The gender/race/ethnicity/veteran data is collected for program reporting purposes only. It has no
bearing on credit decision. Disclosure is voluntary.
λ - This information is for SBA only.
1) Name
% owned
Social Security No.
*Gender
M
F
Title/Management Position
Complete Address
EIB-SBA Form 84-1, Revised 01/2017
3.
OMB No.: 3048-003
Expiration Date: 03/31/2020
λ
λ
λ
Date of Birth
Place of Birth
Race
* (one or more boxes may be selected.)
American Indian or Alaskan Native
Black or African American
E-mail Address
Asian
Native Hawaiian or Pacific Islander
White
λ
Ethnicity
*:
Hispanic or Latino
Not Hispanic or Latino
Military Service Statusλ* (choose one):
Non-Veteran
Veteran
Service Disabled Veteran
2) Name
% owned
Social Security No.
*Gender
M
F
Title/Management Position
Complete Address
λ
λ
λ
Date of Birth
Place of Birth
Race
* (one or more boxes may be selected.)
American Indian or Alaskan Native
Black or African American
E-mail Address
Asian
Native Hawaiian or Pacific Islander
White
λ
Ethnicity
*:
Hispanic or Latino
Not Hispanic or Latino
Military Service Statusλ* (choose one):
Non-Veteran
Veteran
Service Disabled Veteran
3) Name
% owned
Social Security No.
*Gender
M
F
Title/Management Position
Complete Address
λ
λ
λ
Date of Birth
Place of Birth
Race
*
(one or more boxes may be selected.)
American Indian or Alaskan Native
Black or African American
E-mail Address
Asian
Native Hawaiian or Pacific Islander
White
λ
Ethnicity
*:
Hispanic or Latino
Not Hispanic or Latino
Military Service Statusλ* (choose one):
Non-Veteran
Veteran
Service Disabled Veteran
3. Borrower’s Affiliate(s) If more than one affiliate, please attach separate sheet of paper.
Company Name
Telephone No.
Fax No.
D&B No.
Federal ID No.
Name and Title of Contact Person
E-mail Address
Street Address
County of Business
City
State
Zip+4
(No P.O. Boxes)
Number of Employees for each affiliate
Describe Nature of Affiliation
EIB-SBA Form 84-1, Revised 01/2017
4.
OMB No.: 3048-003
Expiration Date: 03/31/2020
4. Personal and/or Corporate Guarantor(s)
If more than one guarantor, please attach separate sheet of paper.
λ - This information is for SBA only.
Name
Federal ID No.
(last, first middle initial)
(if applicable)
λ
λ
Social Security No.
Telephone No.
Fax No.
Date of Birth
Place of Birth
Street Address
County of Business
State
E-mail Address
City
Zip+4
5. Lender
Yes
No
Lender Name
Federal ID No.
New to Ex-Im?
Yes
No
New to SBA?
(If new to Ex-Im or SBA, submit annual report)
Name and Title of Contact Person
Telephone No.
Fax No.
(last, first middle initial)
Street Address
City
State
Zip+4
E-mail Address
EIB-SBA Form 84-1, Revised 01/2017
5.

Download SBA EIB-SBA Form 84-1 Joint Application for Export Working Capital Guarantee

723 times
Rate
4.6(4.6 / 5) 43 votes
ADVERTISEMENT

Related forms