SBA PPP Application
Contact Information
Name
*
First Name
Last Name
Phone Number
*
Email
*
example@example.com
Business Name
*
Tax Identification #
*
Primary Business Location
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Relationship Information
Are you an existing APFCU member?
*
Yes
No
If you are working with a member representative, enter their name below.
First Name
Last Name
Submit the Paycheck Protection Program Borrower Application Form here:
*
Browse Files
Cancel
of
Upload supporting documentation.
*
Browse Files
Cancel
of
Did you apply for or receive an EIDL advance?
*
Yes, I applied for it
Yes, I received an advance
No
Are you or your business currently in Bankruptcy?
*
Yes
No
Have you received a PPP loan already?
*
Yes
No
Have you applied for a PPP loan with another institution?
*
Yes
No
Compensation (e.g., Salaries,Wages, Commissions, and CashTips (Total from 2019*)
For employees making over$100,000 annually, please subtract the amount over$100,000 for each employee and add that amount here. (Total from 2019*)
Vacation, Parental, Family,Medical or Sick Leave (Total from 2019* )
Group Health Insurance (Total from 2019*)
Retirement Plan Funding Paid by Employer (e.g., 401(k)match) (Total from 2019*)
State/Local Taxes on Employee Compensation (i.e., EmployerUC Tax) (Total from 2019*)
Self-Employment Income (andSub-Contractors) not to exceed$100,000 per year per selfemployed persons (Total from 2019*)
Potential Maximum Loan Amount
In order to submit your Application to the Small Business Administration, we must identify the names of individuals, or entities, who have an aggregate ownership of 20% or more. Please list the Applicant’s owners and the respective ownership percentage.
Owner Name
Title
Percent of Ownership
1
2
3
4
5
6
7
8
9
10
Submit
Should be Empty: