SBA Form 5c — Apply for a SBA Disaster Loan as a Homeowner or Renter
Summary
SBA Form 5c, headed “Apply for a SBA Disaster Loan as a Homeowner or Renter,” OMB No. 3245-0018 with an expiration date of 07/31/26, for applying for a low-interest, long-term SBA loan for physical damage caused by a declared disaster. The form asks for the disaster number, whether the applicant applied to FEMA, whether the applicant owns or rents the property, which items were damaged, and homeowner’s, flood, car, windstorm and fire insurance details. It then collects identity, contact, income and optional demographic information for the primary applicant and a joint applicant, followed by an assets section. The closing text includes a notice citing 15 U.S.C. 1601 et seq., a rescission notice under “Regulation Z” and an estimated burden of 1.25 hours.
Summary drafted by a model from the document's text below and checked by script against that text before publication. It is a navigation aid, not a reading of what the document proves. Where AI is used
Archived specimen for the record — not for filing; current forms are at sba.gov.
Cite this document
“SBA Form 5c — Apply for a SBA Disaster Loan as a Homeowner or Renter.”
Original at legacy.sba.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/sba-form-5c-disaster-home-loan-application-2025-02-d8050448c3/
, SHA-256 98034ba716e10a602596e39384f8b01817d02eb3b088ce0c90cfe4b431e9a3e0.Full text
Apply for a SBA Disaster Loan
OMB No. 3245-0018
Expiration Date: 07/31/26
as a Homeowner or Renter
Use this form to apply for a low-interest, long-term loan from the SBA
for physical damage caused by a declared disaster.
Information to prepare
In order to fill out this application completely,
it may be helpful to collect the following items:
• Your most recent federal tax return
• Information about the insurance policies on your home, and personal details for
yourself and any Joint Borrower that you want to include in this application
• You will also need what is called a disaster number, which helps the government
identify the exact occurrence. You can find this at sba.gov/disaster
Disaster declaration
DISASTER NUMBER
1 Which disaster event affected you?
e.g. TX - 01234
To qualify for a disaster loan from SBA, your
home needs to be affected by a federally-
declared disaster. These disasters have a
five-digit Disaster Number following the state
abbreviation.
T sba.gov/disaster
or at a Disaster Recovery Center.
2 Have you applied for help from the Yes, I have applied for help from FEMA
Federal Emergency Management No, I have not applied for help from FEMA
Agency (FEMA)?
Please note that this is not always available.
Please confirm with your local Disaster
Recovery Center or online at sba.gov/disaster
2a If yes, what is your FEMA
registration number?
This is a 9-digit number
SBA Form 5c (05/23) | Previous editions obsolete 1 of 24
Where it’s located
3 What is the address for the home ADDRESS LINE 1
impacted by this disaster?
Provide the address for the home that was
damaged by the disaster event ADDRESS LINE 2 (Optional)
CITY STATE
ZIP CODE
About your home
4 Do you own or rent this property? I am a renter at this property
I own this property individually
I own this property jointly
This property is held by a trust
4a If held by a trust, provide LEGAL NAME OF TRUST
the name of the trust
Include additional contact
information, if applicable NAME OF TRUSTEE
EMAIL ADDRESS
SBA Form 5c (05/23) | Previous editions obsolete 2 of 24
About your home, continued
5 Is this your primary residence? Yes, this is my primary home
This means you live there for most of the year
No, this is not my primary home
and it is the address for your tax return
5a If no, select from the This is a vacation / secondary home
following options
I own the property but a family member or
If this is not a primary friend lives at the property
residence for you, a friend, or a
family member, you may need This is a rental / business property
to apply as a business
What was damaged
6 What items were damaged If you are the owner of this home, select all that apply:
or destroyed?
The structure of my home
Select all that apply
My furniture and personal possessions
My car, boat, motorcycle or other personal vehicle
If you are a renter of this home, select all that apply:
The structure of my home (only for ‘lease to own’ renters)
My furniture and personal possessions
My car, boat, motorcycle or other personal vehicle
SBA Form 5c (05/23) | Previous editions obsolete 3 of 24
Insurance coverage
7 If you have Homeowner’s or Renter’s NAME OF HOMEOWNER’S OR RENTER’S INSURANCE COMPANY
Insurance, provide the following
information
If not, leave blank. INSURANCE POLICY NUMBER
If you have received money from your
insurance already, please make note of the
amount in the last box. If you have not but
expect to, be aware that we will need to know CURRENT AMOUNT RECEIVED FROM INSURANCE COMPANY, IF ANY
that number later in the process.
NAME OF FLOOD INSURANCE COMPANY
8 If you have Flood Insurance, provide
the following information
If not, leave blank.
INSURANCE POLICY NUMBER
If you have received money from your
insurance already, please make note of the
amount in the last box.
CURRENT AMOUNT RECEIVED FROM INSURANCE COMPANY, IF ANY
NAME OF CAR INSURANCE COMPANY
9 If you have Car Insurance, provide the
following information
If not, leave blank. INSURANCE POLICY NUMBER
If you have received money from your
insurance already, please make note of the
amount in the last box.
CURRENT AMOUNT RECEIVED FROM INSURANCE COMPANY, IF ANY
SBA Form 5c (05/23) | Previous editions obsolete 4 of 24
Insurance coverage, continued
10 If you have Windstorm Insurance, NAME OF WINDSTORM INSURANCE COMPANY
provide the following information
If not, leave blank.
If you have received money from your INSURANCE POLICY NUMBER
insurance already, please make note of the
amount in the last box.
CURRENT AMOUNT RECEIVED FROM INSURANCE COMPANY, IF ANY
NAME OF FIRE INSURANCE COMPANY
11 If you have separate Fire Insurance,
provide the following information
If not, leave blank.
INSURANCE POLICY NUMBER
If you have received money from your
insurance already, please make note of the
amount in the last box.
CURRENT AMOUNT RECEIVED FROM INSURANCE COMPANY, IF ANY
SBA Form 5c (05/23) | Previous editions obsolete 5 of 24
About you - Primary Applicant
12 What is your legal name? FIRST NAME
Provide the full name of the primary person
applying for this loan
MIDDLE NAME (Optional)
LAST NAME
13 What is your date of birth? MONTH DAY YEAR
Provide the month, day, and year
14 What is your Social Security Number?
Provide your 9-digit SSN or ITIN
- -
15 Are you married? Yes, I am married
Provide your current marital status, which No, I am not married
helps us to confirm your information with the
IRS.
16 Are you a United States citizen? Yes, I am a United States citizen
If your answer is “No,” we may contact you No, I am not a United States citizen
to learn more about your citizenship status.
You may need to provide a copy of specific
documents like a green card or proof of
permanent residency.
16a If no, please provide a
registration number.
This is the “alien registration
number” provided by US
I do not have a registration number
Citizenship and Immigration.
SBA Form 5c (05/23) | Previous editions obsolete 6 of 24
How to contact you - Primary Applicant
17 What is your email address?
This is the primary method that we will use to
contact you about your application, and will
be used for logging in to our online portal. I do not have an email address
This email may also be used to send you
closing documents for signing on your loan
18 What is your primary phone number?
We will use this number to contact you for
- -
questions and updates about your application
I want to receive updates about my loan via text message
(optional, messaging rates may apply)
- -
18a Do you have an additional phone
number we should use?
We will use this number if we cannot
reach your primary phone number
19 What is the best address for ADDRESS LINE 1
you to receive mail? (optional)
We understand that you may need to move
as part of the process of recovery, and we will ADDRESS LINE 2 (Optional)
be sending all of our notifications through our
online portal, email, or phone to reach you as
quickly as possible
If you have an additional address where you CITY STATE
would like to receive letters about your loan,
you can provide that here
ZIP CODE
SBA Form 5c (05/23) | Previous editions obsolete 7 of 24
Job and finances - Primary Applicant
20 When the disaster occurred, Yes, I had a job that provided me income.
did you have an income?
Yes, I was retired and received retirement benefits.
No, I was not working or receiving income before the
disaster event.
21 Before the disaster happened, how
ANNUAL INCOME - SINGLE INDIVIDUAL
much money did you make each year? $
If you file taxes jointly with another person,
you can provide your joint income instead.
or
Include all reoccurring income such as
employment, self-employment, part-time
work, social security, retirement income, ANNUAL INCOME - HOUSEHOLD / FILING JOINTLY
disability income, child support, alimony, etc.
$
Do not include one-time or non-recurring
income.
For help in providing this number, you can
check your paystubs, W-2, or 1099.
22 How many people rely NUMBER OF DEPENDENTS - SINGLE INDIVIDUAL
on your income?
This is usually the number of children and
adults listed as dependents on your tax return.
If you file taxes jointly with another person, you
or
can provide your joint number of dependents.
NUMBER OF DEPENDENTS - HOUSEHOLD / FILING JOINTLY
SBA Form 5c (05/23) | Previous editions obsolete 8 of 24
Demographic information - Primary Applicant
23a Are you a veteran, I am a veteran
or the spouse of a veteran?
I am a service-disabled veteran
Optional, Select all that apply
I am the spouse of a veteran
I am not a veteran
Prefer not to answer
23b Sex Male
Optional
Female
Prefer not to answer
23c What is your ethnicity? Hispanic or Latino
Optional Not Hispanic or Latino
Prefer not to answer
23d What is your race? American Indian or Alaska Native
Optional, Select all that apply Asian
Black or African American
Native Hawaiian or Pacific Islander
White
Prefer not to answer
Note
Veteran, sex, race, and ethnicity data is collected for program reporting only.
Disclosure is voluntary and has no bearing on the loan decision.
SBA Form 5c (05/23) | Previous editions obsolete 9 of 24
Joint Applicant
24 Do you want to include a Yes, I want to include a joint applicant .......... FILL OUT QUESTIONS 24A - 24S
joint applicant for this loan?
A Joint Applicant can be your
No, I do not want to include a joint applicant ............. SKIP TO QUESTION 25
spouse or another person who
will repay the loan with you
About you - Joint Applicant
24a What is your legal name? FIRST NAME
Provide the full name of the joint applicant
for this loan
MIDDLE NAME (Optional)
LAST NAME
24b What is your date of birth? MONTH DAY YEAR
Provide the month, day, and year
24c What is your Social Security Number?
Provide your 9-digit SSN or ITIN
- -
24d Are you married? Yes, I am married
Provide your current marital status No, I am not married
24e Are you a United States citizen? Yes, I am a United States citizen
If your answer is “No,” we may contact you No, I am not a United States citizen
to learn more about your citizenship status.
You may need to provide a copy of specific
documents like a green card or proof of
permanent residency.
SBA Form 5c (05/23) | Previous editions obsolete 10 of 24
How to reach you - Joint Applicant
24f What is your email address?
This is the primary method that we will use to
contact you about your application, and will
be used for logging in to our online portal. I do not have an email address
This email may also be used to send you
closing documents for signing on your loan
24g What is your primary phone number?
We will use this number to contact you for
- -
questions and updates about your application
I want to receive updates about my loan via text message
(optional, messaging rates may apply)
Do you have an additional phone
- -
24h
number we should use?
We will use this number if we cannot
reach your primary phone number
24i What is the best address for Use the same mailing address as the primary applicant
you to receive mail? (optional)
or
We understand that you may need to move
as part of the process of recovery, and we will
be sending all of our notifications through our ADDRESS LINE 1
online portal, email, or phone to reach you as
quickly as possible.
If you have an additional address where you
ADDRESS LINE 2 (Optional)
would like to receive letters about your loan,
you can provide that here.
If you use the same mailing address as the
primary applicant, check the box above
CITY STATE
ZIP CODE
SBA Form 5c (05/23) | Previous editions obsolete 11 of 24
Job and finances - Joint Applicant
24j When the disaster occurred, did you Yes, I had a job that provided me income.
have an income?
Yes, I was retired and received retirement benefits.
No, I was not working or receiving income before the
disaster event.
24k Before the disaster happened, how ANNUAL INCOME - SINGLE INDIVIDUAL
much money did you make each year? $
If you file taxes jointly with another person,
you can provide your joint income instead. If
or
that person is the primary applicant, please
check the button that indicates this. ANNUAL INCOME - HOUSEHOLD / FILING JOINTLY
Include all reoccurring income such as
employment, self-employment, part-time $
work, social security, retirement income,
disability income, child support, alimony, etc.
I file taxes jointly with the Primary Applicant
Do not include one-time or non-recurring
income.
For help in providing this number, you can
check your paystubs, W-2, or 1099.
24l How many people rely NUMBER OF DEPENDENTS - SINGLE INDIVIDUAL
on your income?
This is usually the number of children and
adults listed as dependents on your tax return.
or
If you file taxes jointly with another person, you
can provide your joint number of dependents. NUMBER OF DEPENDENTS - HOUSEHOLD / FILING JOINTLY
If your dependents are shared with the joint
applicant and represented there, please check
the button that indicates this rather than
providing a number so they are not double
My dependents are reflected in the Primary Applicant’s
counted.
answer above.
SBA Form 5c (05/23) | Previous editions obsolete 12 of 24
Demographic information - Joint Applicant
24m
Are you a veteran, I am a veteran
or the spouse of a veteran?
Optional, Select all that apply
I am a service-disabled veteran
I am the spouse of a veteran
I am not a veteran
Prefer not to answer
24n Sex Male
Optional Female
Prefer not to answer
Hispanic or Latino
24o What is your ethnicity?
Optional Not Hispanic or Latino
Prefer not to answer
American Indian or Alaska Native
24p What is your race?
Optional, Select all that apply Asian
Black or African American
Native Hawaiian or Pacific Islander
White
Prefer not to answer
Note
Veteran, sex, race, and ethnicity data is collected for program reporting only.
Disclosure is voluntary and has no bearing on the loan decision.
SBA Form 5c (05/23) | Previous editions obsolete 13 of 24
Assets - All Applicants
25 What value did you have in the following assets
before the disaster event occurred?
Include combined assets from all applicants
applying for this loan
25a Cash, bank accounts,
and marketable securities $
Includes stocks, bonds, and certificates of
deposit. Do not include retirement accounts
25b Retirement accounts
This can include IRAs, Keogh, TSP and similar
$
accounts for retirement savings
25c Personal property
The pre-disaster value of assets like furniture,
$
appliances, vehicles, boats, and RVs
25d Primary residence
The pre-disaster value of your primary home
$
25e All other real estate
If you have additional real estate to include as
$
assets, provide its value and a description
SBA Form 5c (05/23) | Previous editions obsolete 14 of 24
Debts and obligations - All Applicants
26 Primary residence MORTGAGE HOLDER OR LANDLORD’S NAME
The monthly payment for the mortgage or
rent on your primary home at the time that the
disaster event occurred
MONTHLY PAYMENT / RENT CURRENT BALANCE
$ $
26a Additional mortgage ADDITIONAL MORTGAGE HOLDER NAME
If you have a second mortgage,
provide that information here.
If you need more space for
MONTHLY PAYMENT CURRENT BALANCE
additional mortgages, add
additional sheets
$ $
26b Insurance not included REAL ESTATE TAXES
in monthly payment $ per year
Provide these amounts only if
they are not already included HOMEOWNER’S INSURANCE
in your monthly rent or
mortgage payment $ per year
CONDO / TOWNHOME / HOA / CO-OP FEES
$ per year
27 Other debt NAME OF CREDITOR
Include any fixed debts that you pay monthly,
such as child support, student loans, and credit
extensions within the last 90 days.
MONTHLY PAYMENT CURRENT BALANCE
Do not include any medical debt, or any debts
that will last less than 10 months. $ $
NAME OF CREDITOR
MONTHLY PAYMENT CURRENT BALANCE
$ $
SBA Form 5c (05/23) | Previous editions obsolete 15 of 24
Debts and obligations, continued - All Applicants
If you need more space, attach additional sheets NAME OF CREDITOR
MONTHLY PAYMENT CURRENT BALANCE
$ $
NAME OF CREDITOR
MONTHLY PAYMENT CURRENT BALANCE
$ $
NAME OF CREDITOR
MONTHLY PAYMENT CURRENT BALANCE
$ $
NAME OF CREDITOR
MONTHLY PAYMENT CURRENT BALANCE
$ $
NAME OF CREDITOR
MONTHLY PAYMENT CURRENT BALANCE
$ $
SBA Form 5c (05/23) | Previous editions obsolete 16 of 24
Criminal background and delinquencies - All applicants
28 Is the following true for you or your joint applicant?
28a Filed bankruptcy in the past 2 years Yes No
28b Have outstanding judgments, tax liens, Yes No
or pending lawsuits against them
28c Presently incarcerated, or on probation or parole Yes No
following conviction for a serious criminal offense
28d In the past year, been convicted of a felony Yes No
committed during and in connection with a riot or
civil disorder or other declared disaster
28e Ever been engaged in the production or Yes No
distribution of a product or service that has been
determined obscene by a court of competent
jurisdiction
28f Currently more than 60 days late on Yes No
paying any child support obligations
28g Currently suspended or debarred from Yes No
contracting with the Federal government
or receiving Federal grants or loans
If you answered “Yes” to any of the questions above, use this space to provide dates
and details about each occurrence. If you need more space, attach additional sheets.
SBA Form 5c (05/23) | Previous editions obsolete 17 of 24
Paid Agent Information
29 Did you pay anyone to support you in AGENT FULL NAME
completing this application?
This could be an accountant, packager, or
attorney that worked for a fee.
AGENT COMPANY (If applicable)
If yes, provide their name, company, and any
fee charged or agreed upon for their services
ADDRESS LINE 1
ADDRESS LINE 2 (Optional)
CITY STATE
ZIP CODE
FEE FOR SERVICES
$
SBA Form 5c (05/23) | Previous editions obsolete 18 of 24
E-SIGN Disclosure and Consent
30 Do you consent to using electronic signatures and electronic communications?
While you are currently filling out a paper form, there may come a time or opportunity where you would
like to receive or sign documents electronically. By checking this consent box, you give us permission
to communicate with you electronically (including billing notifications). In addition, this consent gives us
permission to use your electronic signature for any future documents.
Please read the following information carefully. By checking “I Agree”, you are agreeing that you have reviewed this information and consent to
conduct business with the U.S. Small Business Administration using Electronic Communications and using an electronic signature instead of a
written signature. Communications provided to you in electronic format will be considered to be “in writing” in accordance with the Electronic
Signatures in Global and National Commerce Act.
In this document: “SBA” means the U.S. Small Business Administration; “You” and “your” means the signatory authorized to enter this agreement;
“Communication” or “Electronic Communication” means each disclosure, contract, agreement, statement, record, document, invoice, or other
information that SBA provides to you or that you submit to SBA that may be required by law; and, “Loan” or “transaction” means the SBA Disaster
Loan to which you are applying.
Consent to Use Electronic Signatures: You consent to using electronic signatures for all documents, contracts, agreements, or disclosures
related to this loan. You agree that your use of any device, means, or action to provide your electronic signature constitutes your acceptance and
agreement to the terms and conditions of each document as if actually signed by you in writing. You also agree that no certification authority
or other third party verification is necessary to validate your electronic signature, and that the lack of such certification or third party verification
will not in any way affect the enforceability of your electronic signature. You are confirming that you are the party authorized to enter into this
agreement. You further agree that each use of your electronic signature constitutes your agreement to be bound by the terms and conditions of
each document.
Consent to Electronic Communications: You consent to use and receipt of Communications in electronic format. This consent covers all
Communications related to this transaction. Your consent remains in effect unless and until it is withdrawn. Note that SBA may nevertheless
provide you with some Communications in written, signed, or nonelectronic form.
Withdrawing Consent: You may withdraw your consent to Electronic Communications at any time by opting out in the Loan Application Portal or by
sending your request in writing to DisasterCustomerService@sba.gov.
This withdrawal will become effective within a reasonable period of time to process your withdrawal. Withdrawal does not apply to any
Electronic Communications provided or made available to you prior to the effectiveness of the withdrawal.
There are no conditions, consequences, or fees associated with withdrawing your consent.
Your Right to Receive Paper Copies: You may print a paper copy of any Electronic Communication, or request a copy by contacting the SBA
Disaster Customer Service Center at DisasterCustomerService@sba.gov or 1-800-659-2955. There is no fee for requesting a paper copy of an
Electronic Communication.
Hardware and Software Requirements: To access, view, and retain Electronic Communications, you must have:
• A connection to the Internet; • A printer, hard drive, or other storage device
• A supported Internet Browser; if you wish to print or download and save Electronic
Communications; and,
• Software that is capable of receiving, accessing, and
displaying Electronic Communications from SBA, • A device and operating system that supports the above.
whether presented online, in email, or in PDF form;
Changes to Hardware and Software Requirements: If SBA’s hardware and/or software requirements change, and that change would create a
material risk that you would not be able to access or retain your Electronic Communications, SBA will give you notice of the revised hardware or
software requirements, including a reminder of your right to withdraw consent to Electronic Communications.
You Must Keep Your Contact Information Current: You are responsible for maintaining current contact information, such as email addresses and
cell phone number, with SBA to continue receiving Electronic Communications. You may update your contact information by contacting the SBA
Disaster Customer Service Center at DisasterCustomerService@sba.gov or 1-800-659-2955.
Yes, I consent to electronic signatures and electronic communications
No, I do not consent to electronic signatures and electronic communications
SBA Form 5c (05/23) | Previous editions obsolete 19 of 24
Consent and signatures
31 Do you agree to the following terms?
If you agree, sign below with your signature and today’s date.
If you have a co-applicant, they are required to sign and date as well.
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.
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.
If my loan is approved, I may be eligible for mitigation – additional funds up to 20 percent of the total SBA verified physical losses - to safeguard
my property from future damages. I am not obligated to accept these additional funds. If I do accept these additional funds for mitigation, I
agree to only use them for mitigation purposes as specified in my loan agreement.
I have received and read a copy of the “STATEMENTS REQUIRED BY LAWS AND EXECUTIVE ORDERS” which was attached to this application.
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).
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.
SIGNATURE OF PRIMARY APPLICANT OR DESIGNATED TRUSTEE SIGNATURE OF JOINT APPLICANT
MONTH DAY YEAR MONTH DAY YEAR
SBA Form 5c (05/23) | Previous editions obsolete 20 of 24
Additional information about this form
This form is for use by individual homeowners or renters to apply for an SBA physical disaster loan as applicable.
The requested information is required to obtain a benefit under our SBA Disaster Home Loan Program and helps
the Agency determine whether the applicant is eligible for a disaster loan and has repayment ability.
If you have questions about this application and how to submit it or problems providing the required information,
please contact our Customer Service Center at 1-800-659-2955 or disastercustomerservice@sba.gov. If more
space is needed for any section of this application, please attach additional sheets.
You may submit the form:
• Online on SBA’s secure website www.sba.gov
• In-person at a disaster recovery center
• By mail: U.S. Small Business Administration, Processing and Disbursement
14925 Kingsport Rd. Ft. Worth, TX 76155-2243
SBA will contact you by phone or email to discuss your loan request.
Filing requirements
Required for all loan applications:
• Complete and sign this application form (SBA Form 5C)
• Complete and sign the Tax Information Authorization (IRS Form 4506C) enclosed with this application. This
income information, obtained from the IRS, will help us determine your repayment ability
While not necessary to accept your application, you may be required to supply the following
information to process the application. If requested, please provide within 7 days of the
information request:
• If any applicant has changed employment within the past two years, provide a copy of a current (within 1
month of the application date) pay stub for all applicants
• If we need additional income information, you may be asked to provide copies of your Federal income tax
returns, including all schedules
If SBA approves your loan, we may require the following items before loan closing.
We will advise you, in writing, of the documents we need.
• If you own your residence, a COMPLETE legible copy of the deed, including the legal description of the
property
• If the damaged property is your primary residence, proof of residency at the damaged address
• If you had damage to a manufactured home, a copy of the title. If you own the lot where the home is located,
a COMPLETE legible copy of the deed, including the legal description of the property
• If you have damage to an automobile or other vehicle, proof of ownership (a copy of the registration, title,
bill of sale, etc.)
SBA Form 5c (05/23) | Previous editions obsolete 21 of 24
Statements required by Laws and Executive Orders
Note: Please read, detach, and keep for your records
To comply with legislation passed by the Congress and Executive Orders issued by the President, Federal
executive agencies, including the Small Business Administration (SBA), must notify you of certain information. You
can find the regulations and policies implementing these laws and Executive Orders in Title 13, Code of Federal
Regulations (CFR), Chapter 1, or our Standard Operating Procedures (SOPs). In order to provide the required
notices, the following is a brief summary of the various laws and Executive Orders that affect SBA’s Disaster Loan
Programs.
The Small Business Act, Public Law (PL) 85-536 authorizes the Small Business Administration (SBA) to collect
the information on this form. Your disclosure of the information is voluntary. However, failure to disclose certain
information may delay the processing of your eligibility or denial. The SBA will not deny eligibility if you refuse to
disclose your Social Security Number. This information is collected to participate in a loan or grant to determine
eligibility for a SBA program. The information collected may be released to appropriate Federal, State and Local
Agencies, credit bureaus and Servicing agents when relevant to civil, criminal, or regulatory proceedings or to
enforce regulations by manual or automated verification procedures.
STATEMENT REGARDING LOBBYING (APPLICABLE ONLY TO LOANS EXCEEDING $150,000)
If any funds have been paid or will be paid to any person for influencing or attempting to influence an officer
or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with this commitment providing for the United States to provide a loan, the
Applicant(s) will complete and submit Standard Form LLL, “Disclosure of Lobbying Activities,” in accordance with
13 CFR Part 146. Applicant(s) acknowledges submission of this disclosure is a prerequisite for making or entering
into this transaction imposed by Section 1352, Title 31, U.S. Code, and that any person who fails to file or amend
a declaration required to be filed or amended will be subject to a civil penalty in the amounts set forth in 13 CFR
§146.400.
FREEDOM OF INFORMATION ACT (5 U.S.C. 552)
This law provides, with some exceptions, that we must make records or portions of records contained in our files
available to persons requesting them. This generally includes aggregate statistical information on our disaster
loan programs and other information such as names of borrowers (and their officers, directors, stockholders or
partners), loan amounts at maturity, the collateral pledged, and the general purpose of loans. We do not routinely
make available to third parties your proprietary data without first doing pre-notification, as required by Executive
Order #12600, or confidential business information, information that would cause competitive harm, or information
that would constitute a clearly unwarranted invasion of personal privacy.
Send a request under this Act to the SBA office maintaining the records requested and identify it as a Freedom of
Information Act (FOIA) request. The request must describe the specific records you want. For information about
the FOIA, contact the Chief, FOI/PA Office, 409 3rd Street, SW, Suite 5900, Washington, DC 20416, or by e-mail at
foia@sba.gov.
PRIVACY ACT (5 U.S.C. 552a)
Anyone can request to see or get copies of any personal information that we have in your file. Any personal
information in your file that is retrieved by individual identifiers, such as name or social security number is
protected by the Privacy Act, which means requests for information about you may be denied unless we have your
written permission to release the information to the requestor or unless the information is subject to disclosure
under the Freedom of Information Act. The Agreements and Certifications section of this form contains written
permission for us to disclose the information resulting from this collection to state, local or private disaster relief
services.
SBA Form 5c (05/23) | Previous editions obsolete 22 of 24
Statements required by Laws and Executive Orders, continued
The Privacy Act authorizes SBA to make certain “routine uses” of information protected by that Act. One such
routine use for SBA’s loan system of records is that when this information indicates a violation or potential violation
of law, whether civil, criminal, or administrative in nature, SBA may refer it to the appropriate agency, whether
Federal, State, local or foreign, charged with responsibility for or otherwise involved in investigation, prosecution,
enforcement or prevention of such violations. Another routine use of personal information is to assist in obtaining
credit bureau reports on Disaster Loan Applicants and guarantors for purposes of originating, servicing, and
liquidating Disaster loans. See, 86 FR 64979 (and as amended from time to time) for additional background and
other routine uses.
Under the provisions of the Privacy Act, you are not required to provide social security numbers. (see exception
under Debt Collection Act below) We use social security numbers to distinguish between people with a similar or
the same name for credit decisions and for debt collection purposes. Failure to provide this number may not affect
any right, benefit or privilege to which you are entitled by law, but having the number makes it easier for us to
more accurately identify to whom adverse credit information applies and to keep accurate loan records.
Note: Any person concerned with the collection, use and disclosure of information, under the Privacy Act may
contact the Chief, FOI/PA Office, 409 3rd Street, SW, Suite 5900, Washington, DC 20416 or by e-mail at foia@sba.
gov for information about the Agency’s procedures relating to the Privacy Act and the Freedom of Information Act.
DEBT COLLECTION ACT OF 1982; DEFICIT REDUCTION ACT OF 1984; DEBT COLLECTION IMPROVEMENT ACT
OF 1996 & other titles (31 U.S.C. 3701 et seq.)
These laws require us to aggressively collect any delinquent loan payments and to require you to give your
taxpayer identification number to us when you apply for a loan. If you receive a loan and do not make payments
when they become due, we may take one or more of the following actions (this list may not be exhaustive):
• Report the delinquency to credit reporting bureaus.
• Offset your income tax refunds or other amounts due to you from the Federal Government.
• Refer the account to a private collection agency or other agency operating a debt collection center.
• Suspend or debar you from doing business with the Federal Government.
• Refer your loan to the Department of Justice.
• Foreclose on collateral or take other actions permitted in the loan instruments.
• Garnish wages.
• Sell the debt.
• Litigate or foreclose.
RIGHT TO FINANCIAL PRIVACY ACT OF 1978 (12 U.S.C. § 3401 et seq.)
This notifies you, as required by the Right to Financial Privacy Act of 1978 (Act), of our right to access financial
records held by financial institutions that were or are doing business with you or your business. This includes
financial institutions participating in loans or loan guarantees.
The law provides that we may access your financial records when considering or administering Government loan
or loan guaranty assistance to you. We must give a financial institution a certificate of our compliance with the Act
when we first request access to your financial records. No other certification is required for later access. Our access
rights continue for the term of any approved loan or loan guaranty. We do not have to give you any additional
notice of our access rights during the term of the loan or loan guaranty.
We may transfer to another Government authority any financial records included in a loan application or about an
approved loan or loan guaranty as necessary to process, service, liquidate, or foreclose a loan or loan guaranty.
We will not permit any transfer of your financial records to another Government authority except as required or
permitted by law.
SBA Form 5c (05/23) | Previous editions obsolete 23 of 24
Statements required by Laws and Executive Orders, continued
CONSUMER CREDIT PROTECTION ACT (15 U.S.C. 1601 et seq.)
This legislation gives an applicant who is refused credit because of adverse information about the applicant’s
credit, reputation, character or mode of living an opportunity to refute or challenge the accuracy of such reports.
Therefore, if we decline your loan in whole or in part because of adverse information in a credit report, you will
be given the name and address of the reporting agency so you can seek to have that agency correct its report, if
inaccurate. If we decline your loan in whole or in part because of adverse information received from a source other
than a credit reporting agency, you will be given information but not the source of the report.
Within 3 days after the consummation of the transaction, any recipient of an SBA loan which is secured in whole
or in part by a lien on the recipient’s residence or household contents may rescind such a loan in accordance with
“Regulation Z” of the Federal Reserve Board.
PLEASE NOTE: The estimated burden for completion of this form, including gathering the information and
completing and reviewing the response, is 1.25 hours. You are not required to respond to this information
collection unless a valid OMB control number is displayed. The number for this collection of information is
3245-0018. If you have any questions or comments concerning this estimate or other aspects of this information
collection, please contact the U.S. Small Business Administration, Director, Records Management Division, 409 3rd
Street, S.W., Washington, DC 20416, and/or SBA Desk Officer, Office of Management and Budget, New Executive
Office Building, Room 10202, Washington, DC 20503.
PLEASE SUBMIT OR RETAIN THE COMPLETED FORM ACCORDING TO THE INSTRUCTIONS ABOVE.
PLEASE DO NOT SEND FORMS TO OMB.
SBA Form 5c (05/23) | Previous editions obsolete 24 of 24
File and source
- File
- sba-form-5c-disaster-home-loan-application-2025-02.pdf
- Size
- 614,477 bytes
- SHA-256
- 98034ba716e10a602596e39384f8b01817d02eb3b088ce0c90cfe4b431e9a3e0
- Original
- legacy.sba.gov