Jefferson County Revolving Loan Fund Application

Description of Application and Selection Process

The OCRA COVID-19 Response Revolving Loan Fund (RLF) is a quick-response, low documentation loan program for small and micro businesses located in Jefferson County with at least 51% of low to moderate income (LMI) jobs. Funds are available for low to moderate income businesses only. The Loan Terms provided on the following page of this application details the general terms of the OCRA COVID-19 Response Revolving Loan Fund.

Loan funds can be used for payroll, working capital, and remote work capabilities all with the intention of retaining LMI jobs.

The purpose of the fund is to provide quick and easy financial relief for Jefferson County small and micro businesses.

The prospective borrower may submit an application, business recovery plan, and self-scoring sheet and submit it electronically, or the prospective borrower can pick up an application at the Madison, IN Visitor’s Center at 601 W. First Street. The application will have a self-score sheet attached for the applicant to assess where they will score on the loan application. An income survey will also be required for the business owner to fill out. This can be found with the application. The applicant will also have to provide a recovery plan for their business showing their intent to be self-sufficient.

After the application has been submitted, the Loan Manager will call the applicant to go over the application and fill in any information that might have been left out. The Loan Manager holds the ability to discard of an application should it not meet the basic loan criteria. Once the phone review has been completed and the loan application has been approved by the Loan Manager, the Jefferson County Loan Selection Committee will review the application. A score will be given to the loan application based upon subjective and objective criteria. The score of the application will determine how much the applicant can take out in loans and the term of the loan. After the Loan Selection Committee approves the application and gives the application a final scoring, the applicant will receive a call-back from the Loan Selection Committee with the application status and other information.

The selection process consists of a scoring sheet based upon both objective and subjective criteria. Extra scoring points will be given to veteran, women, and minority-owned businesses; and businesses located in the National Historic Landmark District. The amount of points an applicant can receive is based upon the need of the business and the number of low to moderate income (LMI) employees they employ.

AUTHORITY TO COLLECT PERSONAL INFORMATION: This information is provided pursuant to Public Law 93-579 (Privacy Act of 1974).

EFFECTS OF NON-DISCLOSURE: Omission of an item means your application might not receive full consideration.

I/We authorize disclosure of all information submitted in connection with this application to the financial institution agreeing to participate in the loan.

As consideration for any Management and Technical Assistance that may be provided, I/WE waive all claims against RLF and its consultants.

__________________________________________________

I. CHECKLIST FOR APPLICATION PACKAGE

A number of the Exhibits noted below may be addressed within your Business Plan in which case they do not need to be separately labeled. Please mark “BP” next to those items.

Yes No N/A 1. Have you filled out the Income Survey found on www.visitmadison.org/JCRevolvingLoanFund? Please include it with this application.

Yes No N/A 2. Was your business in existence in 2019 and conducted business?

Yes No N/A 3. Has your business been profitable in the past three years?

Yes No N/A 4. Are all your taxes paid and up to date?

Yes No N/A 5. Have you included a business plan for your business?

Yes No N/A 6. Have you included a brief statement of how the COVID-19 pandemic has affected your business?

Yes No N/A 7. For micro businesses, have you included tax forms to verify LMI status?

Yes No N/A 8. For small businesses, have you included paystubs to verify LMI status?

Yes No N/A 9. Have you included the statements listed below? 1, 2, 3 for 2019 through to the date of application submission.

Balance Sheet or Income and Expenses
Past due amounts for 2020
Debt incurred because of the COVID-19 pandemic

Yes No N/A 10. Have you included a personal reference?

Yes No N/A 11. Have you included a business reference?

How Do We Score Our Loans ? Click here

LOAN TERMS:

The OCRA COVID-19 Response Revolving Loan Fund Program will consist of loans that have a term between 3 and 5 years. Per OCRA guidelines, at the discretion of the Jefferson County Loan Selection Committee, a business may have their payments deferred for the first 6 months of the loan term at a 0% interest rate. OCRA guidelines also allow for loans to be forgiven after 2 years of payment and turned into a grant. This is also to the discretion of the Loan Selection Committee.

The minimum amount a business can borrow is $5,000 and the maximum is $25,000. The loan amounts will be based upon the applicant’s application and the objective and subjective scoring. The loans will have a low interest rate at 2%. Payments will be made monthly through EFT.

Jefferson County Revolving Loan Fund Application

INSTRUCTIONS FOR APPLICATION FORM. All information in this application is confidential. SECTIONS I, II, III. Please provide the information requested. “You” refers to the owner, general partner, or proprietor signing this form.

Step 1 of 3

II. APPLICANT INFORMATION
Name*
First Last
Home Street Address*
Street Address Address Line 2 City State ZIP Code
Cell Phone*
Email*
Gender*
Are you a veteran?*
- Yes
- No
Ethnicity?*
III. BUSINESS INFORMATION
Name of Business*
Business Street Address*
Street Address Address Line 2 City State ZIP Code
County*
Business Phone*
IRS Employer ID#*
- Check here is sole proprietor using social security #
Number of Employees*
Number of LMI Employees*
(LMI: Low to Moderate Income)
For purposes of disbursement upon approval. **Do not have to fill out unless approved.**
Business Bank Name
Account #

IV. OWNERSHIP AND MANAGEMENT*
List the name of all owners, general partners, or proprietors. Provide the percent of ownership and the annual compensation. If necessary, attach additional sheets and label “Section III. Ownership and Management.”
1.) Name & Title*
1.) % Ownership*
1.) Address*
Street Address Address Line 2 City State ZIP Code
1.) Annual Compensation*
2.) Name & Title
2.) % Ownership
2.) Address
Street Address Address Line 2 City State ZIP Code
2.) Annual Compensation
SECTION IV.
Use of the loan money: please include how the loan money will be used in your Business Recovery Plan. Uses of money include payroll, working capital, and remote work. Your Business Recovery Plan must also include any collateral you intend to use and its value. Below, please indicate the amount you wish to borrow and the desired loan term.
Desired Loan Amount*
Desired Loan Term: Answer ____ Years ____Months*
Upload your Business Recovery Plan*
Drop files here or

Accepted file types: pdf, doc.

CERTIFICATION: I/WE CERTIFY:*
I/We Certify the following:
A.) All information in this application and the Exhibits is true and complete to the best of my/our knowledge and is submitted to the COVID-19 RLF Loan Selection Committee so the Loan Selection Committee can decide whether to grant a loan or participate with a lending institution in a loan to me/us.

B.) I/WE give the assurance that we will comply with sections 112 and 113 of volume 13 of the Code of Federal Regulations. These Code sections prohibit discrimination on the ground of race, color, religion, marital status, handicap, age, or national origin by recipients of Federal financial assistance and require appropriate reports and access to books and records. These requirements are applicable to anyone who buys or takes control of the business. I/WE realize that if I/WE do not comply with these non-discrimination requirements the RLF Loan Selection Committee can call, terminate, or accelerate repayment of my/our loan.

C.) The RLF Loan Selection Committee may require a personal credit report (and business credit report where necessary) be attained for each applicant. By my/our signature(s) below, I/WE understand these credit reports will be accessed by the RLF Program Manager.
*
Signature of Applicant
Must stop in 601 W. First Street to provide actual signature or Upload an image of your signature below.
Signature Promise*
- I/We uploaded our signature.
- I/We will be in within 24 hours of application submission to provide official signature. If I/we fail to do so, the application will be incomplete.
Signature File of Applicant
*
Print Name of Applicant
Address*
Street Address Address Line 2 City State ZIP Code
Daytime Phone Number*
Email*
If applicant is partner, sign below
Signature of Applicant Partner
Must stop in 601 W. First Street to provide actual signature or Upload an image of your signature below.
Signature File of Applicant Partner
Date
Date Format: MM slash DD slash YYYY