SBA Intake Form
Business Owner's Name
First Name
Last Name
Name of business (if different from above)
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Phone Number
Please enter a valid phone number.
Business email address
example@example.com
Business EIN number (if you do not have an EIN, please enter you social.
Which program do you want to apply for? (Check ALL that apply)
PPP
EIDL ADVANCE
EIDL LOAN (610 CREDIT SCORE REQUIRED)
Was your business in operation by February 1, 2020?
Yes
No
What is the establishment date of your business?
Did you already receive a PPP or EIDL advance/loan on this business?
Yes
No
Business structure
Single owner LLC
Multiple owner LLC
S-corp or C-corp
Nonprofit
Other
Do you have employees? (Employees are considered W2 workers; not 1099s)
No, it's just me
Yes, 1-5
Yes, 6-10
Yes, 10+
Do you have a bank checking account? If yes, is it personal (sole prop/independent contractor/single LLC) or business checking account?
Yes, personal checking account
Yes, business checking account
Neither
Both
Approximately, how much did your business make in 2019?
Approximately, how much did your business make in 2020?
What documents can you provide if requested today?
Unexpired ID/DL
Proof of bank account
2019 tax information
LLC certificate
DBA (Doing Business As...)
Business License
Articles of formation
Proof of 610+ credit score (only required if requesting an EIDL loan)
Business Owner's SSN
Business owner date of birth
Business owner's address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business owner's phone number
Please enter a valid phone number.
Business Owner's email address
example@example.com
Please upload a picture of the front AND back of your government issued ID/DL. Please lay it flat on a surface. DO NOT hold in your hand and make sure the picture is clear.
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If you have any of the documents listed above, upload them here. This will assist with making the process much smother. If not, don't worry, we can add them later.
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By signing below, you are giving us Pelosi to send you an email with a contact for- and granting permission to move forward with the process. Your signature also designates that you understand your submission of this form and any retainer fee requested is due before the work is done.
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