USBCI Capital Access Program Borrower Application Guide
Revised May 19, 2023
Thank you for participating in the USBCI CAP We look forward to working with you to expand access to capital for small businesses in Utah.
To submit an application, go to https://goed.my.salesforce-sites.com/econ/, select funding opportunities, and then select the USBCI CAP Borrower Application.
Section 1: Overview
Section 2: Lender Information
Question 1: “Name of Financial Institution”
● This field will auto-fill.
Question 2: “USBCI CAP Lender ID”
● Your USBCI CAP Lender ID is the contract number from the Lender’s “USBCI CAP Lender Master Agreement”. This field will auto-fill.
Question 3: “Please attach the financial institution's signed "Lender Use of Proceeds and Conflict of Interest Certification" form”
Question 4: “Please attach the financial institution's signed "Lender Sex Offender Certification" form”
Section 3: Borrower Information
Question 5: “Borrower’s First Name”
● First name of the borrower.
Question 6: “Borrower’s Last Name”
● Last name of the borrower
Question 7: “Business Name”
● Name of the business to be funded.
Question 8: “Business EIN”
● EIN of the borrower. Do not provide a business EIN if it is a Social Security number.
Question 9: “Business Address Line 1”
● Street address of the borrower’s main office or location of the borrower that is primarily benefiting from the USBC Ifunds. If real estate construction financing is involved, enter the street address of the project.
Question 10: “Business Address Line 2”
● See above.
Question 11: “Business City”
● City of the borrower.
Question 12: “Business State”
● State of the borrower
Question 13: “Business Zip Code”
● Zip code of the borrower
Question 14: “Business NAICS Code”
● 2017 North American Industry Classification System (NAICS) codes for the borrower’s industry To find the borrower’s NAICS code, visit http://www.census.gov/eos/www/naics/
Question 15: “Brief Description of Business”
● Please briefly describe the business to be funded.
Question 16: “Year business was opened”
● Year in which the borrower commenced operations.
Question 17: “Form of business organization”
● Legal entity type of the borrower (multiple choice).
Question 18: “If other, please describe your form of business organization”
● See above. Please note, the borrower must be a small business or nonprofit to qualify for this program. business.utah.gov/usbci
Question 19: “Primary Purpose of the Loan”
● Please indicate the primary purpose of the USBCI-supported loan that the borrower obtained. Multiple choice.
Question 20: “If other, please describe the purpose of the loan”
● See above.
Question 21: “Secondary Purpose of the Loan”
● Please indicate the secondary purpose of the USBCI-supported loan that the borrower obtained. Multiple choice.
Question 22: “If other, please describe the purpose of the loan”
● See above.
Question 23: “Climate-aligned Investment”
● Please indicate whether the USBCI-supported loan supports a business that makes climate-aligned investments. Climate-aligned investments may reduce greenhouse gas emissions or promote adaptation to climate change or energy transitions. This could be either in the business’s activities (including its production processes and use of energy, inputs, supply chain services, and/or actions to increase resiliency) or by supplying products and services that contribute to lower emissions. Climate-aligned investments can include:
○ investment supporting weatherization;
○ energy-efficient prefabrication or manufacturing;
○ supply chain use, processes or production resulting in lower emissions;
○ energy site transitions;
○ sustainable and/or climate-smart agriculture and forestry;
○ renewable energy development or implementation (including wind, solar, hydroelectric, biomass, geothermal, and other low-carbon technologies);
○ electric vehicle innovation or use;
○ and other investments that aim to build climate resilience, support adaptation to extreme weather and climate events, and/or mitigate climate change.
Question 24: “Energy- or Climate-Impacted Communities”
● Please indicate whether the USBCI-supported loan supports a small business in a community facing local job losses or business revenue declines due to physical or transition impacts from climate change, including shifts in energy production. Examples of such local job loss or revenue declines include: business.utah.gov/usbci
○ declines due to changes in the economics of producing certain agriculture or food;
○ other natural resource goods;
○ chemical inputs;
○ manufactured products;
○ or service sector outputs due to acute or chronic climate impacts, costs, regulations, or shifts in demand.
● Examples of shifts in energy production include any transition away from fossil fuel extraction, refining, or fossil-based energy generation in the oil, gas, and/or coal sector.
Question 25: “Business Revenue”
● Borrower’s annual gross revenues for the fiscal or calendar year prior to the closing of the loan. This may be the most recent year for which taxes were filed.
Question 26: “Business Net Income”
● Borrower’s net income for the fiscal or calendar year prior to the closing of the loan or investment. This may be the most recent year for which taxes were filed.
Question 27: “Full-Time Equivalent Employees”
● Borrower’s full-time equivalent employees (FTEs), rounded to the nearest whole number, at the time of the closing of the USBCI-supported loan. This is determined by adding the number of full-time employees and number of part-time and seasonal employees as a fraction of a full-time employee.
● For example, if a business has 100 employees working full-time (assume a full-time week of 40 hours) and 50 employees working 20 hours per week, the total number of FTEs would be 125. For seasonal employees, the FTE count is based on a 2,080-hour year, so that an employee who works 520 hours per year counts as 0.25 FTEs.
Question 28: “Expected Jobs Created”
● Number of full-time, part-time, and temporary jobs expected to be created as a direct result of the USBCI-supported loan or investment within two years from the date of the loan closing.
Question 29: “Expected Jobs Retained”
● Number of full-time, part-time, and temporary job losses averted as a direct result of the USBCI-supported loan (not including jobs that were not at risk of being lost.)
Question 30: “Please attach the borrower's signed "Borrower Use of Proceeds and Conflict of Interest Certification" form” business.utah.gov/usbci
Question 31: “Please attach the borrower's signed "Borrower Sex Offender Certification" form”
Question 32: “Does this borrower have a guarantor?”
Question 33: “If yes, please list the borrower's guarantors.”
● Please list the guarantors’ first and last names.
Question 34: “If yes, please attach the guarantor's signed "Guarantor Use of Proceeds and Conflict of Interest Certification" form”
Question 35: “If yes, please attach the guarantor's signed "Guarantor Sex Offender Certification" form”
Section 4: Loan Information
Question 36: “Loan type”
● Please indicate the type of loan:
○ term with a specific repayment schedule and a fixed or floating interest rate
○ revenue-based, income-based, or other performance-contingent payments
○ line of credit
○ bridge, venture debt or other debt whose repayment is contingent on event (with or without interim interest payments)
○ other
Question 37: “If other, please describe:”
● If not one of the above, please describe the loan type.
Question 38: “Total "Project" Loan Amount ($)”
● This is the loan amount necessary to finance the project. This may be different than the “Loan Amount Enrolled in the USBCI CAP” if there is more than one source of financing for the project. This must be under $5 million.
Question 39: “Total Loan Amount Enrolled in USBCI CAP”
● The Total Loan Amount Enrolled in USBCI CAP refers to the portion of the loan enrolled in the USBCI CAP. This may be equal to or less than the Total “Project” Loan Amount and must be under $5 million.
Question 40: “Borrower Fee ($ of loan)”
● This number must equal between 1 - 3.5% of the total loan amount enrolled in USBCI CAP. The borrower and lender fee must be the same.
Question 41: “Lender Fee ($ of loan)”
● This number must equal between 1 - 3.5% of the total loan amount enrolled in USBCI CAP. The borrower and lender fee must be the same.
Question 42: “Borrower + Lender Fee Total ($)”
● This number is the combined total of the borrower and lender fees.
Question 43: “Total Loan Term (Months)”
● Duration of the loan term in months. Provide an estimate if repayment depends on the borrower’s revenue or performance activity.
Question 44: “Total Loan Amortization (Months)”
● Duration of the loan amortization in months. Provide an estimate if repayment depends on the borrower’s revenue or performance activity
Question 45: “Loan APR”
● Annual percentage rate (APR) charged to the borrower The APR is the yearly interest calculated from a sum that’s charged to borrowers, including fees.
Question 46: “Variability of Interest Rate”
● Indicate if the interest rate is a fixed interest rate, an adjustable interest rate, or both a fixed interest rate and an adjustable interest rate.
Question 47: “Interest rate”
● Please provide the interest rate charged to the borrower.
Question 48: “Repayment Schedule”
● Please describe the borrower’s repayment schedule.
Question 49: “Frequency of Interest Payments”
● Please describe the frequency of interest payments paid to the lender.
Question 50: “Other Repayment Terms”
● Please describe any additional material terms that exist for this loan (e.g., percentage of monthly revenues) if the loan is revenue-based or performance-based. If none, please indicate so.
Question 51: “Maximum Interest Rate permitted under the loan.”
● Please describe the maximum interest rate permitted under this loan, not including fees, penalty interest, or other charges.
Question 52: “Total Origination Charges”
● Total dollar amount of charges imposed directly or indirectly by the provider at or before origination as an incident to or a condition of the extension of credit, including charges paid by the borrower at or before origination or that are financed. Charges that are imposed indirectly by the provider include charges by a third party that may pass through the provider to the borrower or that are billed separately.
Question 53: “Total upfront fees or charges paid by the small business. Please note fees cannot exceed 2% for loans greater than $25,000 or $500 for loans under $25,000.”
Question 54: “What percentage of the loan is secured?”
● Please indicate what percentage of the loan is secured.
Question 55: “Date of First Disbursement (Date of Loan)”
● Date that the funds for the USBCI-supported loan were disbursed from the provider to the borrower
Question 56: “Maturity Date”
● Please provide the date on which the borrower’s final payment is due.
Question 57: “Will loan funding be used at the business address listed above?”
● Please indicate yes or no.
Question 58: “If no, where will the loan be used? Please provide the address, city, county, and zip code. ”
Question 59: “Additional Government Funds”
● Dollar amount of other funding from other public or government sources invest at the same time as the SSBCI-supported loan.
Question 60: “Concurrent Private Financing”
● Dollar amount of any private financing that was caused by or resulted from the SSBCI-supported loanand that occurred at or around the same time as the SSBCi-supported loan.
Question 61: “Please certify by typing your name below that the applicant does not have the ability to obtain some or all of the requested funds on reasonable terms from non-Federal sources or the SBA without USBCI assistance. If exempted, please list N/A”
● Written signature
● See the” USBCI CAP Policy” for the policy regarding exemptions
Question 62: “What capital access barrier does USBCI CAP help the borrower overcome?”
Section 4: Declaration of Truth and Accuracy
Please e-sign on behalf of your lending institution.