SBA, PPP 3508S Loan Forgiveness Application + Instructions (PPP Loan Forgiveness Application Form 3508S 508 0)

Summary

SBA PPP Loan Forgiveness Application Form 3508S under OMB Control No. 3245-0407, with an expiration date of 12/31/2020 and a footer dated 10/20. It is for borrowers that received a PPP loan of $50,000 or less, and a borrower that, with its affiliates, received PPP loans totaling $2 million or greater cannot use it. The form asks for the loan amount, the EIDL Advance Amount and Application Number, and the forgiveness amount. Certifications cover the use of funds, payroll costs of at least 60% of the forgiveness amount, and documents submitted to the Lender. The form closes with an optional demographic form and a Paperwork Reduction Act notice estimating 15 minutes to complete.

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                                                 Paycheck Protection Program                              OMB Control No. 3245-0407
                                        PPP Loan Forgiveness Application Form 3508S                        Expiration date: 12/31/2020

A BORROWER MAY USE THIS FORM ONLY IF THE BORROWER RECEIVED A PPP LOAN OF $50,000 OR LESS.
A Borrower that, together with its affiliates, received PPP loans totaling $2 million or greater cannot use this form.
                      Business Legal Name (“Borrower”)                                     DBA or Tradename, if applicable

                              Business Address                                  Business TIN (EIN, SSN)               Business Phone
                                                                                                              (   )     -
                                                                                   Primary Contact                    E-mail Address


SBA PPP Loan Number: ________________________                  Lender PPP Loan Number: __________________________

PPP Loan Amount: _____________________________                 PPP Loan Disbursement Date: ________________________

Employees at Time of Loan Application: ___________             Employees at Time of Forgiveness Application: __________

EIDL Advance Amount: ________________________                  EIDL Application Number: __________________________

Forgiveness Amount: ___________________________
By Signing Below, You Make the Following Representations and Certifications on Behalf of the Borrower:
The Authorized Representative of the Borrower certifies to all of the below by initialing next to each one.
_____    The dollar amount for which forgiveness is requested does not exceed the principal amount of the PPP loan and:
                was used to pay costs that are eligible for forgiveness (payroll costs to retain employees; business mortgage interest
                    payments; business rent or lease payments; or business utility payments);
                includes payroll costs equal to at least 60% of the forgiveness amount;
                if a 24-week Covered Period applies, does not exceed 2.5 months’ worth of 2019 compensation for any owner-
                    employee or self-employed individual/general partner, capped at $20,833 per individual; and
                if the Borrower has elected an 8-week Covered Period, does not exceed 8 weeks’ worth of 2019 compensation for
                    any owner-employee or self-employed individual/general partner, capped at $15,385 per individual.
_____    I understand that if the funds were knowingly used for unauthorized purposes, the federal government may pursue recovery of
         loan amounts and/or civil or criminal fraud charges.
_____    The Borrower has accurately verified the payments for the eligible payroll and nonpayroll costs for which the Borrower is
         requesting forgiveness, and has accurately calculated the forgiveness amount requested.
_____    I have submitted to the Lender the required documentation verifying payroll costs, the existence of obligations and service (as
         applicable) prior to February 15, 2020, and eligible business mortgage interest payments, business rent or lease payments, and
         business utility payments.
_____    The information provided in this application and the information provided in all supporting documents and forms is true
         and correct in all material respects. I understand that knowingly making a false statement to obtain forgiveness of an SBA-
         guaranteed loan is punishable under the law, including 18 USC 1001 and 3571 by imprisonment of not more than five years
         and/or a fine of up to $250,000; under 15 USC 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, under 18 USC 1014 by imprisonment of not more than thirty years
         and/or a fine of not more than $1,000,000.
_____    The tax documents I have submitted to the Lender are consistent with those the Borrower has submitted/will submit to
         the IRS and/or state tax or workforce agency. I also understand, acknowledge, and agree that the Lender can share the
         tax information with SBA’s authorized representatives, including authorized representatives of the SBA Office of
         Inspector General, for the purpose of ensuring compliance with PPP requirements and all SBA reviews.
_____    I understand, acknowledge, and agree that SBA may request additional information for the purposes of evaluating the
         Borrower’s eligibility for the PPP loan and for loan forgiveness, and that the Borrower’s failure to provide information
         requested by SBA may result in a determination that the Borrower was ineligible for the PPP loan or a denial of the
         Borrower’s loan forgiveness application.
The Borrower’s eligibility for loan forgiveness will be evaluated in accordance with the PPP regulations and guidance issued by SBA
through the date of this application. SBA may direct a lender to disapprove the Borrower’s loan forgiveness application if SBA
determines that the Borrower was ineligible for the PPP loan.
_____________________________________________________                                     ____________________________
Signature of Authorized Representative of Borrower                                        Date
____________________________________________________                                      ____________________________
Print Name                                                                                Title

SBA Form 3508S (10/20)
                                                    Paycheck Protection Program
                                            PPP Loan Forgiveness Application Form 3508S

                                      PPP Borrower Demographic Information Form (Optional)

Instructions

    1.   Purpose. Veteran/gender/race/ethnicity data is collected for program reporting purposes only.
    2.   Description. This form requests information about each of the Borrower’s Principals. Add additional sheets if necessary.
    3.   Definition of Principal. The term “Principal” means:
          For a self-employed individual, independent contractor, or a sole proprietor, the self-employed individual, independent
             contractor, or sole proprietor.
          For a partnership, all general partners and all limited partners owning 20% or more of the equity of the Borrower, or any
             partner that is involved in the management of the Borrower’s business.
          For a corporation, all owners of 20% or more of the Borrower, and each officer and director.
          For a limited liability company, all members owning 20% or more of the Borrower, and each officer and director.
          Any individual hired by the Borrower to manage the day-to-day operations of the Borrower (“key employee”).
          Any trustor (if the Borrower is owned by a trust).
          For a nonprofit organization, the officers and directors of the Borrower.
    4.   Principal Name. Insert the full name of the Principal.
    5.   Position. Identify the Principal’s position; for example, self-employed individual; independent contractor; sole proprietor;
         general partner; owner; officer; director; member; or key employee.



 Principal Name                                                            Position

 Veteran           1=Non-Veteran; 2=Veteran; 3=Service-Disabled Veteran; 4=Spouse of Veteran; X=Not
                   Disclosed
 Gender            M=Male; F=Female; X=Not Disclosed
 Race (more than 1 1=American Indian or Alaska Native; 2=Asian; 3=Black or African-American; 4=Native
 may be selected) Hawaiian or Pacific Islander; 5=White; X=Not Disclosed
 Ethnicity         H=Hispanic or Latino; N=Not Hispanic or Latino; X=Not Disclosed

                         Disclosure is voluntary and will have no bearing on the loan forgiveness decision




Paperwork Reduction Act – You are not required to respond to this collection of information unless it displays a currently valid OMB Control
Number. The estimated time for completing this application, including gathering data needed, is 15 minutes. Comments about this time or the
information requested should be sent to Small Business Administration, Director, Records Management Division, 409 3rd St., SW, Washington DC
20416, and/or SBA Desk Officer, Office of Management and Budget, New Executive Office Building, Washington DC 20503. PLEASE DO NOT
SEND FORMS TO THESE ADDRESSES.

SBA Form 3508S (10/20)
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