Council for Native Hawaiian Advancement

Transcription

1 2149 Lauwiliwili Street, Suite 200, Kapolei, Hawaii Tel: / Fax: / info@hawaiiancouncil.org Aloha! Mahalo for your interest in the Council for Native Hawaiian Advancement s (CNHA), Micro- Enterprise Loan Program (MELP). We are proud to serve local businesses and to assist your company in achieving success. In order to make this loan process as smooth and convenient as possible we have supplied a checklist of required documentation located in the supporting documents section of the application. Please complete the application kit and submit with all necessary documentation to our offices. If you should have any questions regarding the Micro-Enterprise Loan Program please do not hesitate to call me by phone at or at info@hawaiiancouncil.org. We look forward to receiving your application. E malama pono, Geri Mendiola Program Manager Enclosed: MELP Application Enhancing the cultural, economic, political, and community development of Native Hawaiians.

2 CNHA BUSINESS LOAN APPLICATION Today s Date: BUSINESS NAME: BUSINESS INFORMATION DATE ESTABLISHED (MM/DD/YYYY): PHYSICAL ADDRESS: CITY: STATE: ZIP: MAILING ADDRESS (IF DIFFERENT FROM PHYSICAL ADDRESS): CITY: STATE: ZIP: PRIMARY CONTACT NAME: TITLE/POSITION: PHONE: WEBSITE: TAX ID/EMPLOYER IDENTIFICATION NUMBER (EIN) 1 : NAICS CODE(S) 2 : DUNS #: 3 TYPE OF BUSINESS: Sole Proprietorship 4 Corporation 5 BRIEFLY DESCRIBE THE BUSINESS: Partnership 6 Limited Liability Corporation 7 Other (please specify): WHAT STAGE IS YOUR BUSINESS IN? Seed Established Succession Start-up Expansion Other (please specify): Growth Mature HAVE YOU APPLIED FOR FINANCING ELSEWHERE IN THE PAST? IF YES, HAVE YOU EVER BEEN DENIED FINANCING? Yes No Yes No DO YOU HAVE A BUSINESS CHECKING ACCOUNT? DO YOU HAVE A BUSINESS SAVINGS ACCOUNT? Yes No Yes No 1 For a sole-proprietorship this number is usually your social security number. An employer identification number (EIN) is a nine-digit number assigned by the IRS. It is used to identify the tax accounts of employers and certain others who have no employees. The IRS uses the number to identify taxpayers who are required to file various business tax returns. EINs are used by employers, sole proprietors, corporations, partnerships, non-profit associations, trusts, estates of decedents, government agencies, certain individuals, and other business entities. If you already have an EIN and the organization or ownership of your business changes, you may need to apply for a new number. Visit this website for more information: 2 If you don t know your NAICS code you can find it at 3 For this Micro-Enterprise Loan Program application, it is required that you register your business on the Dun & Bradstreet iupdate website for a DUNS number. 4 A sole proprietorship, also known as the sole trader or simply a proprietorship, is a type of business entity that is owned and run by one natural person and in which there is no legal distinction between the owner and the business. 5 A corporation (sometimes referred to as a C corporation) is an independent legal entity owned by shareholders. This means that the corporation itself, not the shareholders that own it, is held legally liable for the actions and debts the business incurs. 6 A partnership is a single business where two or more people share ownership. Each partner contributes to all aspects of the business, including money, property, labor or skill. In return, each partner shares in the profits and losses of the business. 7 A limited liability company is a hybrid type of legal structure that provides the limited liability features of a corporation and the tax efficiencies and operational flexibility of a partnership. The "owners" of an LLC are referred to as "members." 1

3 PLEASE CHECK WHICH OF THE FOLLOWING S YOUR BUSINESS CURRENTLY HAS. IF YOUR BUSINESS DOES NOT CURRENTLY HAVE THE, BUT YOU ARE INTERESTED IN IT PLEASE LET US KNOW. NOT INTERESTED IN INTERESTED IN CURRENTLY HAVE TYPE Disadvantage Business Enterprise (DBE) Program 8 Minority Business Enterprise (MBE) Program 9 Emerging Business Enterprise (EBE) Program 10 Women Business Enterprise (WBE) Program 11 Service-Disabled Veteran-Owned Small Business Concern (SDV) Program 12 SBA 8(a) Business Development Program 13 HUB Zone 14 Other (please specify): PLEASE INDICATE HOW MANY EMPLOYEES (INCLUDING OWNER(S)) YOUR BUSINESS WILL EMPLOY AT LOAN CLOSING. FULL-TIME PART-TIME EMPLOYMENT STATUS (35 OR MORE HOURS PER (34 HOURS OR LESS PER WEEK) WEEK) Permanent TOTAL Seasonal PLEASE INDICATE HOW MANY EMPLOYEES (INCLUDING OWNER(S)) YOUR BUSINESS WILL RETAIN AT LOAN CLOSING. FULL-TIME PART-TIME EMPLOYMENT STATUS (35 OR MORE HOURS PER (34 HOURS OR LESS PER WEEK) WEEK) Permanent TOTAL Seasonal PLEASE ESTIMATE THE NUMBER OF JOBS (INCLUDING OWNER(S)) YOU EXPECT TO CREATE, MINUS ANY EXPECTED JOB LOSSES OVER THE NEXT YEAR. FULL-TIME PART-TIME EMPLOYMENT STATUS (35 OR MORE HOURS PER (34 HOURS OR LESS PER WEEK) WEEK) Permanent Seasonal TOTAL In the past year did your business create or retain indirect jobs? 15 Yes No In the next year, does your business plan to create or retain indirect jobs? 16 Yes No How many jobs do you estimate to have impacted due to your use of support industry products and/or services? How many jobs do you estimate you will impact due to your use of support industry products and/or services? 8 The DBE program provides small businesses owned and controlled by socially and economically disadvantaged individuals a fair opportunity to compete for federally funded transportation contracts. 9 The MBE program encourages procurement officers to utilize minority-owned firms in a higher level. 10 The EBE program seeks to assist businesses in obtaining work on construction and professional services contracts, It enables emerging business enterprise to gain knowledge, experience, and resources needed to participate in the competitive process for contracts. 11 The WBE program encourages procurement officers to utilize women-owned firms in a higher level. 12 The purpose of the Service-Disabled Veteran-Owned Small Business Concern Procurement Program is to provide procuring agencies with the authority to set acquisitions aside for exclusive competition among service-disabled veteran-owned small business concerns, as well as the authority to make sole source awards to service-disabled veteran-owned small business concerns if certain conditions are met. 13 The 8(a) Business Development Program is a business assistance program for small disadvantaged businesses. The 8(a) Program offers a broad scope of assistance to firms that are owned and controlled at least 51% by socially and economically disadvantaged individuals. 14 The Historically Underutilized Business Zones (HUBZone) program falls under the auspices of the U.S. Small Business Administration. The program encourages economic development in historically underutilized business zones - "HUBZones" - through the establishment of preferences. SBA's HUBZone program is in line with the efforts of both the Administration and Congress to promote economic development and employment growth in distressed areas by providing access to more federal contracting opportunities. 15 The jobs created or retained by the businesses in support industries (for example, construction materials suppliers, architects, engineers, and other businesses that support a construction project will experience an increase in demand and will create and retain jobs as a result). 2

4 Does your business currently offer your permanent full-time employees health insurance? Yes No In progress vision and/or dental insurance? Yes No In progress paid leave and/or paid time off? Yes No In progress parental leave 16? Yes No In progress retirement/401k? Yes No In progress IF YOU ANSWERED YES OR IN PROGRESS ABOVE, PLEASE DESCRIBE. other benefits (such as career advancement, training, work from home, etc.)? Yes No In progress WHAT WAS YOUR GROSS ANNUAL REVENUE 17 IN THE LAST FISCAL YEAR 18? WHAT WAS YOUR NET ANNUAL BUSINESS PROFIT 19 IN THE LAST FISCAL YEAR 24? $ $ LOAN INFORMATION PLEASE TELL US ABOUT YOUR LOAN REQUEST. Type of business loan this will be: Total Project Cost: $ General Business Working Capital Equipment/Machinery - Inventory Other (please specify): Total Amount Financed from Other Sources: $ Improvements = Artist Agriculture Debt Refinance Green/Sustainable Other (please specify): Total Loan Amount Requested: $ Purpose of the loan: Start-up Expansion Operations Other (please specify): HOW SUSTAINABLE IS YOUR BUSINESS? PLEASE DESCRIBE IN NARRATIVE FORM THE PURPOSE OF THIS BUSINESS LOAN. 16 For example, maternity or paternity leave. 17 In simple terms, revenue is the money earned through sales, services and other means. If you sell a sandwich for $5, your current gross revenue is $5, with the term gross meaning the total amount before subtracting such things as the cost of the meat, bread and staff to make and serve the sandwich. 18 A fiscal year (FY) is a period that a company or government uses for accounting purposes and preparing financial statements. A fiscal year may not be the same as a calendar year, and for tax purposes, the Internal Revenue Service (IRS) allows companies to be either calendar-year taxpayers or fiscal-year taxpayers. 19 Net profit represents the number of sales dollars remaining after all operating expenses, interest, taxes and dividends have been deducted from a company's total revenue. 3

5 PLEASE TELL US ABOUT THE OWNER(S) OF THE BUSINESS DESCRIBED ABOVE. OWNER(S) INFORMATION NAME: TITLE: % OWNERSHIP: SUPPORTING DOCUMENTS PLEASE PROVIDE THE FOLLOWING SUPPORTING DOCUMENTS FOR YOUR BUSINESS LOAN APPLICATION: Completed & signed program application List of Board of Directors/Business Owners Signed Certification & Authorization Form Description of organization/business including mission statement and work (2) Years Federal Corporate Tax Returns related to loan Current year-to-date Profit & Loss Statements, Balance Sheet and Income Business plan and/or business projection Statement Business license and/r Federal Tax ID number Most recent years audited report (if applicable) Request identification of business owner (driver s license, state Copy of business owner s government issued identification identification, other) LEGAL INFORMATION HAVE YOU BEEN INVOLVED IN BANKRUPTCY PROCEEDINGS OR INSOLVENCY PROCEEDINGS OR HAVE PEDNING PERSONAL OR BUSINESS JUDGMENTS, UNSETTLED LAWSUITES OR MAJOR DISPUTES? IF YES, ATTACH EXPLANATION. ARE YOUR BUSINESS AND/OR PERSONAL TAXES PAST DUE? Yes No Yes No 4

6 BORROWER S ACKNOWLEDGEMENT All information provided on this application is true and correct to the best of my knowledge. All sources of household income have been fully disclosed. I authorize CNHA to obtain a credit report in conjunction with this application if applying for credit. I understand that CNHA will rely on the information in this application and/or credit report to make its decision. I understand that my application will be denied if I have provided any false information, or if this application is incomplete I will notify CNHA immediately if there are changes to the information provided in this application. The undersigned certifies the following: 1. I have submitted documentation to the Council for Native Hawaiian Advancement (CNHA) to qualify for the Micro-Enterprise Loan Program (MELP). 2. In requesting the loan, I/We completed an application form containing various information on me and my income information, as well as assets and liabilities. I/We certify that all of the information is true and complete. I/We made no misrepresentations in the application packet in regards to me and/or other documents, nor did I/We omit any pertinent information. 3. I understand and agree that the Council for Native Hawaiian Advancement will review and analyze the information provided from the application to determine my ability to qualify for the Micro-Enterprise Loan Program (MELP). 4. I fully understand that the information provided is specifically for applying for a loan/grant. The information is being used by CNHA in order to identify borrowing potential. AUTHORIZATION TO RELEASE INFORMATION To Whom It May Concern: 1. I have completed a Micro-Enterprise Loan Program (MELP) application from the Council for Native Hawaiian Advancement 2. I understand and agree that the Council for Native Hawaiian Advancement may pull a credit report as part of their due diligence when evaluating my application. 3. A copy of this authorization may be accepted as an original. SIGNATURE DATE 5