1 Business Overview Business Start Date * NAICS Code Total Full-Time Employees Total Part-Time Employees Amount of Sales (Total) $ Emergency Declaration * At the time of the session, is your client's business located in an area with an active state or federal emergency declaration or proclamation? Yes No Industry * Select Industry Accommodation and Food Services Administrative and Support and Waste Management and Remediation Services Agriculture, Forestry, Fishing and Hunting Arts, Entertainment, and Recreation Construction Concern Educational Services Finance and Insurance Health Care and Social Assistance Information Management of Companies and Enterprises Manufacturing Mining Other Services (except Public Administration) Professional, Scientific, and Technical Services Public Administration Real Estate Rental and Leasing Retail Trade Transportation/Warehousing Utilities Wholesale Trade Business Operations * Select Business Operations Pre-Launch Part-Time Operation Full-Time Operation 2 New Funding Since Last TA Session Contracts # of Contracts $ Amount of Contracts $ Loans # of Loans Amount of Loans (SBA & non-SBA) $ Capital & Equity Amount of Equity Capital $ Additional Funds Raised (Non-dilutive) $ 3 Loan Submissions & Approvals Submissions Number of Loans Submitted Number of SSBCI Loans Submitted Number of Non-SSBCI Loans Submitted Backed Loans* Number of SSBCI-backed Loans* Loans approved by iBank/CPCFA lender network Number of Non-SSBCI-backed Loans* Dollar Amounts Received Dollar Amount of Loans Received (Total) $ Dollar Amount of SSBCI-backed Loans* $ Dollar Amount of Non-SSBCI-backed Loans $ SSBCI Venture Program Funds Awarded $ 4 Referrals to Small Business Programs or Capital Sources Small Business Program Referral Name of Small Business Program Referral to Source of Capital Description of Other Lender or Other Investor Submit Form ✓ Form Submitted Thank you. Your business information has been received successfully.
