KSBCI 2.0 Loan Enrollment Form

KSBCI 2.0 Loan Enrollment Form
INSTRUCTIONS

All applicants should familiarize themselves with the information regarding the incentive programs for which application is made as well as other applicable program requirements and the KSBCI Guidelines. Information regarding the KSBCI program is located at:

https://ced.ky.gov/Entrepreneurship/KSBCI

If you are seeking to utilize the KSBCI program to enhance the availability of credit for your small business customers, you must notify Kentucky Innovation within the Kentucky Cabinet for Economic Development. A project manager will be assigned to assist you with your project and determine the incentives for which the project may qualify. No applications will receive consideration without the signature of an agent of the Cabinet.

The online application should be completed and submitted, including the signatures and the required attachments.

If you need assistance with the application, email cedsbsd@ky.gov or call (502) 564-7670.

JOTFORM

This applicaiton has a "save" feature, found at the bottom of each page. If you have already provided your email address you will receive an email from Jotform allowing you to continue your application at a later time.

This application is encrypted, meaning the information included on the applicaiton is only accessible to designated individuals within the Cabinet for Economic Development.

REQUIRED ATTACHMENTS

The following must be submitted through, or in conjunction with, this online application:
1. Signed Certification of Application
2. Signed Lender Incentive Disclosure Statement
3. Signed Lender Use of Proceeds Conflicts Form
4. Signed Lender Sex Offender Form
5. Signed Borrower Incentive Disclosure Statement
6. Signed Borrower Use of Proceeds Conflicts Form
7. Signed Borrower Sex Offender Form
8. A copy of the loan application, credit analysis, and other relevant loan documents
If this application includes a Guarantor that is an entitiy, please submit the following as well:
1. Signed Entity Guarantor Use of Proceeds Conflcits Form
2. Signed Entity Guarantor Sex Offender Form

Lender Information
Lender Name*
Lender Tax ID*
Lender Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Person*

First NameLast Name
Title*
Phone*
Please enter a valid phone number.
Extension (If Applicable)
Email Address*
example@example.com

Co-Borrower Information
Co-Borrower Name
Co-Borrower Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please add the information of any Co-Borrowers

Guarantor Information
Guarantor Name
Guarantor Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please add the information of any Co-Guarantors

Loan Information

Sources of Funds*

	Lender or Equity Investor Name	Amount
Source
Source
Source
Source
Source

Total Sources*
Calculates Automatically from "Sources of Funds"

Use of Funds*

	Use of Funds	Amount
Source
Source
Source
Source
Source

Total Uses*
Calculates Automatically from "Uses of Funds"
Loan Amount*
Amount Requested from KEDFA*
Percent of KSBCI-support Requested*
Expected Closing Date*

MonthDayYear
Date
Loan Type*

TermLine of CreditOther
Lender Loan Term (Months)*
Collateral Support Term (Months)*
Closing Fee*
Loan to Value Prior to KSBCI 2.0 Support (%)*
Loan Annual Percentage Rate (APR)*
Interest Rate Variability*

Fixed interest rateAdjustable interest rateBoth a fixed interest rate and an adjustable interest rate
Maximum interest rate permitted under the loan (not including fees, penalty interest, or other charges).*
Total Origination Charges*
Does this request for KSBCI assistance follow the guidelines for requesting KSBCI assistance submitted by your lending institution at the time of lender registration in the KSBCI 2.0 program?*

YesNo
If you answered "No" to the previous question, please explain the request for exception to submitted lender guidelines.*

Required Application Document Uploads
Required Application Documents Download Links
Please download the following documents using the links provided and upload completed versions in the appropriote sections:
If this application includes a Guarantor that is an entity, please download the following documents using the links provided and upload completed versions in the appropriote sections:
1. Entity Guarantor Use of Proceeds Conflicts Form
2. Entity Guarantor Sex Offender Form
Certification of Application
Please Upload a Completed Certification of Application

Cancelof
Lender Incentive Disclosure Statement
Please Upload a Completed Lender Incentive Disclosure Statement

Cancelof
Lender Use of Proceeds Conflicts Form
Please Upload a Completed Lender Use of Proceeds Conflicts Form

Cancelof
Lender Sex Offender Form
Please Upload a Completed Lender Sex Offender Form

Cancelof
Borrower Incentive Disclosure Statement
Please Upload a Completed Borrower Incentive Disclosure Statement

Cancelof
Borrower Use of Proceeds Conflicts Form
Please Upload a Completed Borrower Use of Proceeds Conflicts Form

Cancelof
Borrower Sex Offender Form
Please Upload a Completed Borrower Sex Offender Form

Cancelof
Entity Guarantor Use of Proceeds Conflicts Form
Please Upload a Completed Entity Guarantor Use of Proceeds Conflicts Form if Applicable

Cancelof
Entity Guarantor Sex Offender Form
Please Upload a Completed Entity Guarantor Sex Offender Form if Applicable

Cancelof
Loan Documents

Additional files necessary to process the application; such as the loan application, credit analysis, and loan approval. You can upload more than one file.
Please Upload Necessary Loan Documents

Cancelof
Should be Empty:

KSBCI 2.0 Loan Enrollment Form

Lender Information

Borrower Information

Co-Borrower Information

Guarantor Information

Project Information

Loan Information

Required Application Document Uploads

Required Application Documents Download Links

Certification of Application

Lender Incentive Disclosure Statement

Lender Use of Proceeds Conflicts Form

Lender Sex Offender Form

Borrower Incentive Disclosure Statement

Borrower Use of Proceeds Conflicts Form

Borrower Sex Offender Form

Entity Guarantor Use of Proceeds Conflicts Form

Entity Guarantor Sex Offender Form

Loan Documents