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Get Sba Form 4 Schedule A

LIST PARCELS OF REAL ESTATE Address Year Acquired Original Cost Market Value Amount of Lien Name of Lienholder Description s SBA Form 4 Schedule A 8-01 Previous Editions Obsolete SUBMIT COMPLETED APPLICATION TO LENDER OF CHOICE This form was electronically produced by Elite Federal Forms Inc. SECTION II - PERSONAL PROPERTY All items listed herein must show manufacturer or make model year and serial number. OMB Approval No* 3245-0016 Expiration Date 11/30/2004 U*S* SMALL BUSINESS ADMINISTRATION SCHEDULE OF COLLATERAL Exhibit A Applicant Street Address City State Zip Code LIST ALL COLLATERAL TO BE USED AS SECURITY FOR THIS LOAN Section I - REAL ESTATE Attach a copy of the deed s containing a full legal description of the land and show the location street address and city where the deed s is recorded* Following the address below give a brief description of the improvements such as size type of construction use number of stories and present condition use additional sheet if more space is required. Items with no serial number must be clearly identified use additional sheet if more space is required. Manufacturer Model Serial No* Year Acquired Original Cost Market Value Current Lien Balance Name of Lienholder All information contained herein is TRUE and CORRECT to the best of my knowldege. If you knowingly make a false statement or overvalue a security to obtain a guaranteed loan from SBA you can be fined up to 10 000 and/or imprisoned for not more than five years under 18 usc 1001 if submitted to a Federally Insured Institution under 18 USC 1014 by Imprisonment of not more than twenty years and/or a fine of not more than 1 000 000. I authorize the SBA s Office of Inspector General to request criminal record information about me from criminal justice agencies for the purpose of determining my eligibility for programs authorized by the Small Business Act as amended* Name Date NOTE The estimated burden for completing this form is 2. 25 hours per response. You will not be required to respond to collection of information unless it displays a currently valid OMB approval number. Comments on the burden should be sent to U*S* Small Business Administration Chief AIB 409 3rd St* SW Washington D*C* 20416 and Desk Officer for Small Business Administration Office of Management and Budget New Executive Office Building Room 10202 Washington D*C* 20503. Items with no serial number must be clearly identified use additional sheet if more space is required. Manufacturer Model Serial No* Year Acquired Original Cost Market Value Current Lien Balance Name of Lienholder All information contained herein is TRUE and CORRECT to the best of my knowldege. Manufacturer Model Serial No* Year Acquired Original Cost Market Value Current Lien Balance Name of Lienholder All information contained herein is TRUE and CORRECT to the best of my knowldege. If you knowingly make a false statement or overvalue a security to obtain a guaranteed loan from SBA you can be fined up to 10 000 and/or imprisoned for not more than five years under 18 usc 1001 if submitted to a Federally Insured Institution under 18 USC 1014 by Imprisonment of not more than twenty years and/or a fine of not more than 1 000 000.

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