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SBA 7(a) Paycheck Protection Loan Request
Small Business Owners may loan up to 2.5 times the monthly payroll costs. You also may be eligible for loan forgiveness after an 8-week period.
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* Indicates required question
Email
*
Your email
Full Name
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Your answer
Your Phone Number
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Your answer
Business Legal Name
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Your answer
Business EIN
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Your answer
Business Phone Number
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Your answer
Business Address
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Your answer
City / State / Zip
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Your answer
2019 Monthly Payroll Costs
Each employee costs the sum of his or her gross wages.
1. Total Gross wages for all employees, including yourself (monthly)
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Your answer
2. Payroll taxes & Unemployment premium for all employees, including yourself (monthly)
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Your answer
3. Health Insurance for all employees, including yourself (monthly)
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Your answer
4. Total Monthly Payroll Costs (add items 1-3)
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Your answer
Requested Loan Amount (monthly payroll costs x 2.5)
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Your answer
Annual Payroll Costs
*Your annual payroll costs should not be greater than your annual gross revenue amount. If it is, then adjust your annual gross revenue amount.
2019 Annual Payroll Costs (multiply item #4 x 12)
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Your answer
2019 Annual Gross Revenue
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Your answer
Monthly Rent or Mortgage
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Your answer
# of Employees as of Dec 31, 2019
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Your answer
# of Employees as of Feb 15, 2020
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Your answer
When was the business established? (MM/YYYY)
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Your answer
What is the legal structure of your business?
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Choose
LLC
S Corp
C Corp
Partnership
Trust
Sole Proprietor
Independent Contractor
Not For Profit
What industry does the business fall under?
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Choose
Accommodation & Food
Construction
Education
Entertainment/Recreation
Finance & Insurance
Healthcare
Information Technology
Manufacturing
Professional Services
Real Estate/Lending/Renting
Retail
Wholesale
Other
Does the applicant business or principal have ownership in another company (or companies)
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Yes
No
Are the majority owners of the business US citizens or legal permanent residents?
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Yes
No
Have you ever defaulted on a government loan (includes SBA Loan, Student Loan, etc.)
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Yes
No
Have you submitted a loan request to SBA or any other Agency or Financial institution in connection with COVID-19
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Yes
No
Disclaimer * By checking this box you agree to have your JW Capital Company Loan Officer and our SBA Direct Lender Partners to reach out to you in regards to your loan inquiry.
*
Yes
Required
A copy of your responses will be emailed to the address you provided.
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