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Paycheck Protection Program
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Partner Code
Agent Code
Affiliate Code
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Business Information
Tell us about your company.
Business Name
If a contractor or sole proprietor, enter your name.
DBA or Trade Name if Applicable
Entity Type
*
Please Select
Independent Contractor
Sole Proprietor
Partnership
LLC
C-Corp
S-Corp
If multiple owners, choose Partnership
State of Formation
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Business Address
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Start Date
 -
Month
 -
Day
Year
Must be before 02/15/2020
Tax ID - EIN/SSN
*
Enter Majority Owner's SSN if company doesn't have an EIN.
Briefly describe your business
NAICS Code (self-assigned)
https://www.naics.com/search/
Is this business a franchise?
*
No
Yes
Franchise Code
New Business?
No
Yes
Seasonal Business?
No
Yes
Woman-Owned Business?
No
Yes
Veteran-Owned Business?
No
Yes
Minority-Owned Business?
No
Yes
Account Type
Please Select
Competitor
Customer
Investor
Partner
Press
Prospect
Reseller
Other
Meets Size Standard
Please Select
Less than 500 employees (300 if applicable)
SBA Industry Size Standards
SBA Alternative Size Standard
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Owner Information
Tell us more about you. No credit check required.
Legal Name
*
Mobile
*
Email
*
Role or Title
*
Please Select
Owner
CEO/President
Director
Member
Board Member
Ownership %
Click here if your Business & Home Address are the same.
Home Address
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Birthdate
*
 -
Month
 -
Day
Year
Social Security Number
*
Used by SBA for Identity Verification
Gender
*
Please Select
Male
Female
Not Disclosed
Veteran
*
Please Select
Non Veteran
Veteran
Service-Disabled Veteran
Spouse of Veteran
Race/Ethnicity
*
Please Select
American Indian or Alaska Native
Asian
Hispanic or Latino
Black or African-American
Native Hawaiian or Pacific Islander
White
Ethnicity
Please Select
Hispanic or Latino
Not Hispanic or Latino
Not Disclosed
How did you hear about us?
Let us know if someone referred you to Blueacorn!
Additional Owners
Besides you, does anyone else own 20% or more of this company?
No
Yes
Besides you, how many other people own more than 20%?
Please Select
1
2
3
Owner 2
Â
Legal Name (Owner 2)
Role or Title (Owner 2)
Please Select
Owner
CEO/President
Director
Member
Board Member
Ownership % (Owner 2)
Home Address (Owner 2)
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Mobile Number (Owner 2)
Email (Owner2)
Birthdate (Owner 2)
 -
Month
 -
Day
Year
Social Security Number (Owner 2)
Gender (Owner 2)
Please Select
Male
Female
Not Disclosed
Veteran (Owner 2)
Please Select
Non Veteran
Veteran
Service-Disabled Veteran
Spouse of Veteran
Not Disclosed
Race (Owner 2)
Please Select
American Indian or Alaska Native
Asian
Black or African-American
Native Hawaiian or Pacific Islander
White
Not Disclosed
Ethnicity (Owner 2)
Please Select
Hispanic or Latino
Not Hispanic or Latino
Not Disclosed
Owner 3
Â
Legal Name (Owner 3)
Role or Title (Owner 3)
Please Select
Owner
CEO/President
Director
Member
Board Member
Ownership % (Owner 3)
Home Address (Owner 3)
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Mobile Number (Owner 3)
Email (Owner 3)
Birthdate (Owner 3)
 -
Month
 -
Day
Year
Social Security Number (Owner 3)
Gender (Owner 3)
Please Select
Male
Female
Not Disclosed
Veteran (Owner 3)
Please Select
Non Veteran
Veteran
Service-Disabled Veteran
Spouse of Veteran
Not Disclosed
Race (Owner 3)
Please Select
American Indian or Alaska Native
Asian
Black or African-American
Native Hawaiian or Pacific Islander
White
Not Disclosed
Ethnicity (Owner 3)
Please Select
Hispanic or Latino
Not Hispanic or Latino
Not Disclosed
Owner 4
Â
Legal Name (Owner 4)
Role or Title (Owner 4)
Please Select
Owner
CEO/President
Director
Member
Board Member
Ownership % (Owner 4)
Home Address (Owner 4)
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Mobile Number (Owner 4)
Email (Owner 4)
Birthdate (Owner 4)
 -
Month
 -
Day
Year
Social Security Number (Owner 4)
Gender (Owner 4)
Please Select
Male
Female
Not Disclosed
Veteran (Owner 4)
Please Select
Non Veteran
Veteran
Service-Disabled Veteran
Spouse of Veteran
Not Disclosed
Race (Owner 4)
Please Select
American Indian or Alaska Native
Asian
Black or African-American
Native Hawaiian or Pacific Islander
White
Not Disclosed
Ethnicity (Owner 4)
Please Select
Hispanic or Latino
Not Hispanic or Latino
Not Disclosed
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Financial Information
If your company issues 1099s to contractors, they need to apply for their own PPP loan.Â
Did this business get a PPP in Round 1?
*
No
Yes
Who funded your first PPP loan?
How much was your first PPP loan?
SBA Loan Number (Round 1)
Does your company issue W2s to employees?
No
Yes
Does the owner get a W2?
Yes
No
Does anyone in your company make more than $100K per year?
No
Yes
How many people make more than $100K per year?
Include owners and employees
Compensation
Annual Payroll
Enter for 2019 or 2020 (whichever is higher) to maximize PPP.
Number of Employees
Including owner, how many people work at this company?
Self-Employment Income (2019)
Schedule C form is included in your personal tax return.
Self-Employment Income (2020)
Enter this number If 2020 income is higher than 2019 to maximize your PPP.
Total Payroll in Q1 2020
If no employees, enter your compensation Jan-Mar 2020.
PPP Calculator
Calculation based on 2019 Compensation
Estimated PPP for No Payroll
Estimated PPP for Payroll + Owner Draw
Estimated PPP for Payroll
Estimated PPP for Partnership
Estimated PPP for New Business
Min Tester
Calculation based on 2019 Compensation
Number of Partners
Partner Income (Owner 1)
Partner Income (Owner 2)
Partner Income (Owner 3)
Leave blank, if applicable.
Partner Income (Owner 4)
Leave blank, if applicable.
Partner Income (Owner 5)
Leave blank, if applicable.
Partner Income (Owner 2) - Capped
Cap at $100k.
Partner Income (Owner 3) - Capped
Cap at $100k.
Partner Income (Owner 1) - Capped
Cap at $100k.
Partner Income (Owner 4) - Capped
Cap at $100k.
Partner Income (Owner 5) - Capped
Cap at $100k.
Partnership Calculation
Cap at $100k.
Requested PPP Amount
We double-check to ensure calculation is done properly.
Average Monthly
Calculation based on 2019 Compensation
Is there anything else we should know about this business?
Revenue Analysis (Second PPP Draw)
To qualify for a second PPP, you need to show at least one 25% decline quarter over quarter.
Estimate your business revenue for each quarter in 2019 and 2020. The chart will auto-calculate the quarter over quarter difference for you!
Â
Q1 (Jan-Mar)
Q2 (Apr-June)
Q3 (July-Sept)
Q4 (Oct-Dec)
Total
2019
2020
Change (%)
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Legal Disclosures
This information supports your PPP loan application.
The purpose of the loan (select all that apply):
*
Payroll Costs
Rent/Mortgage Interest
Utilities
Covered Operations Expenditures
Covered Property Damage
Covered Supplier Costs
Covered Worker Protection Expenses
Other
1st Draw PPP: To qualify, every question should be marked no, except #7.
Â
Yes
No
1. Is the Applicant or any owner of the Applicant presently suspended, debarred, proposed for debarment, declared ineligible, voluntarily excluded from participation in this transaction by any Federal department or agency, or presently involved in any bankruptcy?
2. Has the Applicant, any owner of the Applicant, or any business owned or controlled by any of them, ever obtained a direct or guaranteed loan from SBA or any other Federal agency that is (a) currently delinquent, or (b) has defaulted in the last 7 years and caused a loss to the government?
3. Is the Applicant or any owner of the Applicant an owner of any other business, or have common management (including a management agreement) with any other business? If yes, list all such businesses (including their TINs if available) and describe the relationship on a separate sheet identified as addendum A.
4. Did the Applicant receive an SBA Economic Injury Disaster Loan between January 31, 2020 and April 3, 2020? If yes, provide details on a separate sheet identified as addendum B.
5. Is the Applicant (if an individual) or any individual owning 20% or more of the equity of the Applicant presently incarcerated or, for any felony, presently subject to an indictment, criminal information, arraignment, or other means by which formal criminal charges are brought in any jurisdiction?
6. Within the last 5 years, for any felony involving fraud, bribery, embezzlement, or a false statement in a loan application or an application for federal financial assistance, or within the last year, for any other felony, has the Applicant (if an individual) or any owner of the Applicant 1) been convicted; 2) pleaded guilty; 3) pleaded nolo contendere; or 4) commenced any form of parole or probation (including probation before judgment)?
7. Is the United States the principal place of residence for all employees included in the Applicant’s payroll calculation above?
2nd Draw PPP: To qualify, every question should be marked no, except #6.
Â
Yes
No
1. Is the Applicant or any owner of the Applicant presently suspended, debarred, proposed for debarment, declared ineligible, voluntarily excluded from participation in this transaction by any Federal department or agency, or presently involved in any bankruptcy?
2. Has the Applicant, any owner of the Applicant, or any business owned or controlled by any of them, ever obtained a direct or guaranteed loan from SBA or any other Federal agency that is (a) currently delinquent, or (b) has defaulted in the last 7 years and caused a loss to the government?
3. Is the Applicant or any owner of the Applicant an owner of any other business, or have common management (including a management agreement) with any other business? If yes, list all such businesses (including their TINs if available) and describe the relationship on a separate sheet identified as addendum A.
4.Â
Is the Applicant (if an individual) or any individual owning 20% or more of the equity of the Applicant presently incarcerated or, for any felony, presently subject to an indictment, criminal information, arraignment, or other means by which formal criminal charges are brought in any jurisdiction?
5.Â
Within the last 5 years, for any felony involving fraud, bribery, embezzlement, or a false statement in a loan application or an application for federal financial assistance, or within the last year, for any other felony, has the Applicant (if an individual) or any owner of the Applicant 1) been convicted; 2) pleaded guilty; 3) pleaded nolo contendere; or 4) commenced any form of parole or probation (including probation before judgment)?
6. Is the United States the principal place of residence for all employees included in the Applicant’s payroll calculation above?
Owner's Initials
1st Draw PPP: The authorized representative of the applicant must certify in good faith by initialing next to each statement below.
Â
Initial
Initial here to confirm your response to question 5 above.
Initial here to confirm your response to question 6 above.
The Applicant was in operation on February 15, 2020, has not permanently closed, and was either an eligible self-employed individual, independent contractor, or sole proprietorship with no employees, or had employees for whom it paid salaries and payroll taxes or paid independent contractors, as reported on Form(s) 1099-MISC.
Current economic uncertainty makes this loan request necessary to support the ongoing operations of the Applicant.
The funds will be used to retain workers and maintain payroll; or make payments for mortgage interest, rent, utilities, covered operations expenditures, covered property damage costs, covered supplier costs, and covered worker protection expenditures as specified under the Paycheck Protection Program Rules; I understand that if the funds are knowingly used for unauthorized purposes, the federal government may hold me legally liable, such as for charges of fraud.
I understand that loan forgiveness will be provided for the sum of documented payroll costs, covered mortgage interest payments, covered rent payments, covered utilities, covered operations expenditures, covered property damage costs, covered supplier costs, and covered worker protection expenditures, and not more than 40% of the forgiven amount may be for non-payroll costs. If required, the Applicant will provide to the Lender and/or SBA documentation verifying the number of full-time equivalent employees on the Applicant’s payroll as well as the dollar amounts of eligible expenses for the covered period following this loan.
The Applicant has not and will not receive another loan under the Paycheck Protection Program, section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) (this does not include Paycheck Protection Program second draw loans, section 7(a)(37) of the Small Business Act (15 U.S.C. 636(a)(37)).
The Applicant has not and will not receive a Shuttered Venue Operator grant from SBA.
The President, the Vice President, the head of an Executive department or a Member of Congress, or the spouse of such person as determined under applicable common law, does not directly or indirectly hold a controlling interest in the Applicant, with such terms having the meanings provided in Section 322 of the Economic Aid to Hard-Hit Small Businesses, Nonprofits and Venues Act.
The Applicant is not an issuer, the securities of which are listed on an exchange registered as a national securities exchange under section 6 of the Securities Exchange Act of 1934 (15 U.S.C. 78f).
I further certify that the information provided in this application and the information provided in all supporting documents and forms is true and accurate in all material respects. I understand that knowingly making a false statement to obtain a guaranteed loan from SBA is punishable under the law, including under 18 U.S.C. 1001 and 3571 by imprisonment of not more than five years and/or a fine of up to $250,000; under 15 U.S.C. 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 U.S.C. 1014 by imprisonment of not more than thirty years and/or a fine of not more than $1,000,000.
I acknowledge that the Lender will confirm the eligible loan amount using required documents submitted. I understand, acknowledge, and agree that the Lender can share any tax information that I have provided with SBA’s authorized representatives, including authorized representatives of the SBA Office of Inspector General, for the purpose of compliance with SBA Loan Program Requirements and all SBA reviews.
2nd Draw PPP: The authorized representative of the applicant must certify in good faith by initialing next to each statement below.
Â
Initial
Initial here to confirm your response to question 4 above.
Initial here to confirm your response to question 5 above.
The Applicant was in operation on February 15, 2020, has not permanently closed, and was either an eligible self-employed individual, independent contractor, or sole proprietorship with no employees, or had employees for whom it paid salaries and payroll taxes or paid independent contractors, as reported on Form(s) 1099-MISC.
Current economic uncertainty makes this loan request necessary to support the ongoing operations of the Applicant.
The Applicant has realized a reduction in gross receipts in excess of 25% relative to the relevant comparison time period. For loans of $150,000 or less, Applicant will provide documentation substantiating the decline in gross receipts upon or before seeking loan forgiveness for the Second Draw Paycheck Protection Program Loan or upon SBA request.
The Applicant received a First Draw Paycheck Protection Program Loan and, before Second Draw Paycheck Protection Program Loan is disbursed, will have used the full amount (including any increase) of the First Draw Paycheck Protection Program Loan only for eligible expenses.
The f
unds will be used to retain workers and maintain payroll; or make payments for mortgage interest, rent, utilities, covered operations expenditures, covered property damage costs, covered supplier costs, and covered worker protection expenditures as specified under the Paycheck Protection Program Rules; I understand that if the funds are knowingly used for unauthorized purposes, the federal government may hold me legally liable, such as for charges of fraud.
I
understand that loan forgiveness will be provided for the sum of documented payroll costs, covered mortgage interest payments, covered rent payments, covered utilities, covered operations expenditures, covered property damage costs, covered supplier costs, and covered worker protection expenditures, and not more than 40% of the forgiven amount may be for non-payroll costs. If required, the Applicant will provide to the Lender and/or SBA documentation verifying the number of full-time equivalent employees on the Applicant’s payroll as well as the dollar amounts of eligible expenses for the covered period following this loan.
The Applicant has not and will not receive another Second Draw Paycheck Protection Program Loan.
The Applicant has not and will not receive a Shuttered Venue Operator grant from SBA.
The President, the Vice President, the head of an Executive department or a Member of Congress, or the spouse of such person as determined under applicable common law, does not directly or indirectly hold a controlling interest in the Applicant, with such terms having the meanings provided in Section 322 of the Economic Aid to Hard-Hit Small Businesses, Nonprofits and Venues Act.
The applicant is not an issuer, the securities of which are listed on an exchange registered as a national securities exchange under section 6 of the Securities Exchange Act of 1934 (15 U.S.C. 78f)
The Applicant is not a business concern or entity (a) for which an entity created in or organized under the laws of the People's Republic of China or the Special Administrative Region of Hong Kong, or that has significant operations in the People's Republic of China or the Special Administrative Region of Hong Kong, owns or holds, directly or indirectly, not less than 20 percent of the economic interest of the business concern or entity, including as equity shares or a capital or profit interest in a limited liability company or partnership; or (b) that retains, as a member of the board of directors of the business concern, a person who is a resident of the People's Republic of China.
The Applicant is not required to submit a registration statement under secion 2 of the Foreign Agents Registration Act of 1938 (22 U.S.C.612)
The Applicant is not a business concern or entity primarily engaged in political or lobbying activities, including any entity that is organized for research or for engaging in advocacy in areas such as public policy or political strategy or otherwise describes itself as a think tank in any public documents.
I f
urther certify that the information provided in this application and the information provided in all supporting documents and forms is true and accurate in all material respects. I understand that knowingly making a false statement to obtain a guaranteed loan from SBA is punishable under the law, including under 18 U.S.C. 1001 and 3571 by imprisonment of not more than five years and/or a fine of up to $250,000; under 15 U.S.C. 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 U.S.C. 1014 by imprisonment of not more than thirty years and/or a fine of not more than $1,000,000.
I acknowledge that the Lender will confirm the eligible loan amount using required documents submitted. I understand, acknowledge, and agree that the Lender can share any tax information that I have provided with SBA’s authorized representatives, including authorized representatives of the SBA Office of Inspector General, for the purpose of compliance with SBA Loan Program Requirements and all SBA reviews.
E-Signature
By checking this box and typing your name in the field below, the Applicant or Authorized Representative of the Applicant agrees to electronically sign this document and certifies in good faith all information is accurate to the best of their knowledge.
Print Name
Date
 -
Month
 -
Day
Year
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Bank Information
We need your bank account information so we can deposit your PPP funds.
Bank Name
Routing Number
Direct Electronic Transfer
Account Number
Verify Account Number
Verified
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Upload Your Documents
This information supports your PPP loan application.
Driver's License (All Owners)
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Upload your driver's license (or other official ID) for every person who owns more than 20% of this company.
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Bank Statement (February 2020)
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The name on you bank statement should match either the owner's name, the business name or the DBA.
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Voided Check (or Screenshot of Account & Routing Number)
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Account must match your Feb bank statement. It's used to verify your direct deposit information.
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Articles of Incorporation
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Type into Google: "(Your State) Business Entity Search" & find your business to download a digital copy.
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Proof of Good Standing
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Type into Google "(Your State) Business Entity Search" to find your business & prove your status is current, active.
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Schedule C (2019)
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This form is part of your personal tax return. Line 31 verifies your self-employment income from 2019.
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Draft Schedule C (2020)
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Download & fill out a draft Schedule C tax form in good faith to the best of your knowledge. Line 31 verifies your company profits in 2020.
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1099-MISC (2019)
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Only one 1099-Misc from 2019 is needed to support your application.
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Form 940 (2019)
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You file this annual tax form to show how much you paid each W2 employee throughout 2019.
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Payroll Processor Report (2019 Annual)
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Download from your payroll processor (Intuit, Quickbooks) to show how much each employee was paid in 2019.
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Form 941 (Q1 2020)
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This document verifies how much your business spent on payroll in January, February and March of 2020.
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Payroll Processor Report (Q1 2020)
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Download from your payroll processor (Intuit, Quickbooks) to show how much each employee was paid in January, February and March 2020.
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Schedule K-1 2019 (All Owners)
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Each owner of your partnership files a Schedule K-1 as part of your 1065 corporate tax return.
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Profit & Loss Statement (Q1 2020)
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This is a self-prepared statement showing your business profits from January, February and March of 2020.
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Other
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Any other documentation can be uploaded here.
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Submit
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