PIER Small Business Loan Application

PIER Small Business Loan Application

All applications are confidential. This is an initial application. Supplemental financial and eligibility documents will be needed. NOTE: You can save this application and return to it later. Scroll to the bottom of the form and click "Save." You will receive a link in your email to return to your application. Like most webpages, this application will time out if left open for too long. We suggest drafting your application in a document first, then copying and pasting it to the form.
How to Apply:

✅ Preview the Application (Download in Word or PDF) and Eligibility Documents

✅ Connect with an SBDC Business Advisor

Contact Ruthie Painter at the Southern Oregon University SBDC:
📧 painterr@sou.edu | ☎️ (541) 840-4201

✅ Gather required documents and draft your application

Need Help? Technical Assistance is Available

Language Services:
Email us at pier@ivcdo.org in your preferred language. We’ll schedule a meeting with an interpreter at no cost to you.

Nuestros socios del Centro de Desarrollo de Pequeñas Empresas de RCC cuentan con asesores que le ayudarán a crear un plan de negocios y le asistirán con los requisitos de la solicitud sin costo alguno. Comuníquese con el RCC SBDC al 541-956-7494 o envíe un correo electrónico a sbdc@roguecc.edu.

Application Support:
Contact Ruthie Painter at the Southern Oregon University SBDC:
📧 painterr@sou.edu | ☎️ (541) 840-4201

Internet & Printing Access:
Visit Jackson County Library Services.
Roslyn Donald, Business Librarian, is available to assist:
📧 rdonald@jcls.org | ☎️ 541-734-3992
🌐 www.jcls.org/business

General Questions:
Contact IVCanDO at pier@ivcdo.org or call 541-592-4440

Click here to return to the IVCanDO Website
Name*

First NameLast Name
Birth Date*

MonthDayYear
Date
Name of Business*
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Physical Home Address (if different):

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Address (if different):

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number (best to reach you)*
Please enter a valid phone number.
Phone Number (additional number to reach you)
Please enter a valid phone number.
Email*
example@example.com
Social Security Number or ITIN*
Drivers License Number
Employer Identification Number (EIN):
Total # of Employees:*
This number must be under 100
Oregon Business Registry Number:
Find your number here: https://sos.oregon.gov/business/Pages/find.aspx
Unique Entity ID/Proof of Registration on www.sam.gov:
Visit https://sam.gov/entity-registration to look up your SAM.gov Unique Identity Number (note you do not need to register to receive your Unique Identity Number)
Briefly describe your business. What is your product or service? (If not sole proprietorship, please include the names, addresses, and phone numbers for the other owners, partners, or officers): *

0/4000
How was your business affected by the 2020 Labor Day fires?

Please describe the direct or indirect effect below and provide documentation in the attachments.

If you are re-opening a business that closed due to the 2020 Labor Day fires or you are starting a completely new business after the 2020 Labor Day Fires forced you to close a previous business, please include that in the narrative.

If your business is new and you didn’t own a business during the 2020 Labor Day fires, please note how this business will serve fire affected areas or populations.
How was your business affected by the 2020 Labor Day fires?*

0/4000
Has your business received, or do you anticipate receiving, any other funding related to recovery efforts from the 2020 Labor Day Fires? Examples could be FEMA funding, SBA funding, insurance payouts, etc. If yes, please explain below and provide documentation in the attachments. *
Which HUD National Objective(s) do you meet (choose all that apply)? Please attach documents providing proof in the attachments.

The business owner’s combined household income is at or below 80% of area median income (AMI)The business is at risk of losing jobs without this assistanceThe applicant is planning to create new jobs with this fundingThe business serves a low-to-moderate income populationThe business serves an area that might benefit low-to-moderate income populationsUrgent needs including: Businesses that suffered loss of structure, inventory, sales, or property damage due to the 2020 Labor Day Fires.Urgent needs including: Businesses that address existing conditions which pose a serious and immediate threat to the health or welfare of the community.Urgent needs including: Businesses that address a specific need or urgency within the area.Urgent needs including: Projects that respond to the urgency, type, scale, and location described in the ReOregon Action Plan.Urgent needs including: Businesses or projects where, if not funded, there would be a significant negative impact on the community.
Number of Jobs Created/Retained from this Loan *
Is your business located in a 100-year floodplain?*

YesNo
Loan amount requested (up to $50,000): *
Describe the project you are seeking financing for. Include specifically how you will use the funds (for example, cost of each tool or piece of equipment). *

0/4000
What is your background in this field of business? If you do not have a background in this area, tell us what other experience would qualify you for this business. List any relevant degrees, certificates, or training. *

0/4000
How will this investment increase your business profits? How is this loan going to financially improve your business and increase your profits? Will the increase in profits be sufficient to cover your loan payments? Please provide calculations to support your request. *

0/4000
All loans must be backed by collateral. What property do you propose to use as collateral for this loan and what is its resale value? For vehicles, find the private party value from Kelley Blue Book. For equipment, provide documentation of current worth using model, condition, and serial number. For real estate collateral, please provide the address. Please note that primary residences are not eligible as collateral. *

0/3000
Do you have anyone who can co-sign this loan? If so, please list their name, address and phone number. This may be necessary depending on the value of the collateral that you identified. *

0/1000
Please list any credit problems you have or whether you have no credit. (A credit check will be run as part of your application, but a low credit score alone does not disqualify you from receiving a loan)*

0/4000
Have you ever declared bankruptcy? If yes, please explain and give dates. *

0/3000
Do you have any lawsuits pending against you? If yes, please explain.

0/3000
Have you applied for and been denied a loan from a bank or commercial lending institution for your business? If yes, please explain the circumstances for denial. *
Do you currently have any loans or other debt you’ve taken out for your business? If yes, please list the terms, monthly payments, principal, and expected payoff date(s).*
Do you currently have a business mentor? (A qualified person who can answer business questions or provide guidance.) Who is this person and what are their qualifications and experience?*
Would you be willing to work with a business mentor assigned to you from the Southern Oregon University Small Business Development Center?*

YesNoMaybe
Please include three references that are relevant to your business. Include Name, address, phone number, email and relationship. References may be checked. *
Upload Supporting Loan Documents

Please attach documents relevant to your business such as business plans, profit and loss statements, cash flow projections, and personal financial statements. These will strengthen your application.

Review this list with your Loan Advisor to ascertain which documents you need to submit.

I. Business Plan (only required for start-ups), including
- Description of business
- Marketing
- Competition
- Operating procedures
- Personnel
- Business insurance
Please upload Business Plan documents here (only required for start-ups)

Cancelof
Upload Supporting Loan Documents

Review this list with your Loan Advisor to ascertain which documents you need to submit.

II. Financial Data
- Pro-forma income projections (profit & loss statements)
- Balance sheet
- Capital equipment and supply list (if using as collateral)
- Cash flow projections (click to download fillable form)
- Break Even analysis
- Three-year summary
- Detail by month, first year
- Detail by quarters, second and third years
- Assumptions upon which projections were based
- Other Loan applications
Please upload Financial Data documents here:

Cancelof
Upload Supporting Loan Documents

Review this list with your Loan Advisor to ascertain which documents you need to submit.

III. Other Supporting Documents
- Tax returns of principals for last two years
- LMI Household Certification Form (click to download fillable form)
- Cost of Living Budget (click to download fillable form)
- Copy of proposed lease/purchase agreement for building space
- Copy of licenses and other legal documents
- Copy of resumes of all principals
- Copies of letters of intent from suppliers, etc.
Please upload Other Supporting documents here:

Cancelof
Upload Supporting Loan Documents

Review this list with your Loan Advisor to ascertain which documents you need to submit.

IV. PIER Eligibility Documents
- Documents that show how your business was impacted by the 2020 Labor Day Fires
- Documents showing other funding sources or denials (FEMA, SBA, insurance, etc.)
- LMI Household Certification Form (click to download fillable form, use if qualifying as low-to-moderate income business owner)
- LMI Jobs form (if retaining or adding jobs)
Please upload PIER Eligibility supporting documents here:

Cancelof
Read and sign: I certify that I have provided complete and accurate statements on this application. I authorize IVCanDO to run a check on the status of my credit and to contact my references. To the best of my knowledge, all official documents submitted in support of this application are authentic and unaltered records that pertain to me. If found otherwise, I understand it is cause for rejection of this application or for demand of payment on a promissory note given in exchange for a loan that has been based on this application.*

Powered by Jotform SignClear