Exhibit F (EIDL application 2020.07.08) — USA v. Merritts (Dkt. 35-5, D.D.C.)

Record facts

U.S. District Court for the District of Columbia · No. 1:25-cr-00076-JMC · Doc. 35-5 · 2025-12-02 · Docket on CourtListener

Full text

Case 1:25-cr-00076-JMC     Document 35-5     Filed 12/02/25     Page 1 of 4

Case 1:25-cr-00076-JMC     Document 35-5     Filed 12/02/25     Page 2 of 4

Case 1:25-cr-00076-JMC     Document 35-5     Filed 12/02/25     Page 3 of 4

On behalf of the individual owners identified in this application and for the business applying for the loan:
I/We authorize my/our insurance company, bank, financial institution, or other creditors to release to SBA all 
records and information necessary to process this application and for the SBA to obtain credit information about the 
individuals completing this application.
If my/our loan is approved, additional information may be required prior to loan closing. I/We will be advised in 
writing what information will be required to obtain my/our loan funds. I/We hereby authorize the SBA to verify 
my/our past and present employment information and salary history as needed to process and service a disaster 
loan. I/We authorize SBA, as required by the Privacy Act, to release any information collected in connection with this 
application to Federal, state, local, tribal or nonprofit organizations (e.g. Red Cross Salvation Army, Mennonite 
Disaster Services, SBA Resource Partners) for the purpose of assisting me with my/our SBA application, evaluating 
eligibility for additional assistance, or notifying me of the availability of such assistance.
I /We will not exclude from participating in or deny the benefits of, or otherwise subject to discrimination under any 
program or activity for which I/we receive Federal financial assistance from SBA, any person on grounds of age, 
color, handicap, marital status, national origin, race, religion, or sex.
I/We will report to the SBA Office of the Inspector General, Washington, DC 20416, any Federal employee who 
offers, in return for compensation of any kind, to help get this loan approved. I/We have not paid anyone connected 
with the Federal government for help in getting this loan.
CERTIFICATION AS TO TRUTHFUL INFORMATION: By signing this application, you certify that all information in your 
application and submitted with your application is true and correct to the best of your knowledge, and that you will 
submit truthful information in the future.
WARNING: 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.
* Checkbox: 0 = unchecked, 1 = checked
** The checkbox field "I hereby certify UNDER PENTALTY OF PERJURY UNDER THE LAWS OF THE UNITED STATES that the above is true and correct." is preceded by the following statement:
USAO-009613
Case 1:25-cr-00076-JMC     Document 35-5     Filed 12/02/25     Page 4 of 4

File and source

File

gov.uscourts.dcd.278640.35.5.pdf

Size

785,739 bytes

SHA-256

b83796dcd9c8dbb0a096f13f6034791457b7850980df8a4ad791175f1d64e565

Our copy

gov.uscourts.dcd.278640.35.5.pdf

Original

PACER (login required)