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                                          Paycheck Protection  Program                                 OMB Control Number 3245-0407      
                                 Loan Forgiveness Application  Revised June 16, 2020                      Expiration Date: 12/31/202  3 

                                            PPP Loan Forgiveness Calculation Form 

                      Business Legal Name (“Borrower”)                                    DBA or Tradename, if applicable 

                             Business Address                                  Business TIN (EIN, SSN)          Business Phone 
                                                                                                              (   )   -
                                                                                     Primary Contact            E-mail Address 

SBA PPP Loan Number:                                       Lender PPP Loan Number:             

PPP Loan Amount:                                             PPP Loan Disbursement Date:    

Employees at Time of Loan Application:  ___________     Employees at Time of Forgiveness Application: 

EIDL Advance Amount:                                        EIDL Application Number:     

Payroll Schedule:  The frequency with which payroll is paid to employees is:  

☐ Weekly           ☐  Biweekly (every other  week)          ☐    Twice a month         ☐  Monthly      ☐  Other

Covered Period:                                   to    

Alternative Payroll Covered Period,   if applicable:                                to    

If Borrower (together with affiliates, if applicable) received PPP  loans in excess of $2 million, check here:  ☐ 

Forgiveness Amount Calculation: 

Payroll and Nonpayroll Costs 
Line 1. Payroll Costs (enter the amount from PPP Schedule A, line 10): 

Line 2. Business Mortgage Interest Payments:  

Line 3. Business Rent or Lease Payments:  

Line 4. Business Utility Payments: 

Adjustments for Full-Time Equivalency (FTE) and Salary/Hourly Wage Reductions 
Line 5.   Total Salary/Hourly Wage Reduction (enter the amount from PPP Schedule A, line3):    

Line 6.   Add the amounts on lines 1, 2, 3, and 4, then subtract the amount entered in line5:   

Line 7.   FTE Reduction Quotient (enter the number from PPP Schedule A, line13):     

Potential Forgiveness Amounts 
Line 8.   Modified Total (multiply line 6 by line 7): 

Line 9. PPP Loan Amount: 

Line 10. Payroll Cost 60% Requirement (divide line 1 by 0.60): 

Forgiveness Amount  
Line 11. Forgiveness Amount (enter the smallest of lines 8, 9, and 10): 

SBA Form 3508 (06/20) 
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                                            Paycheck Protection Program                                       OMB Control Number 3245-0407 
                                   Loan Forgiveness Application Revised June 16, 2020                              Expiration Date: 12/31/202   3 

By Signing Below, You Make the Following Representations and Certifications on Behalf of  the Borrower:  

The authorized representative of the Borrower certifies to all of the below by initialing next to each one. 

          The dollar amount for which forgiveness is requested: 
              •   was used to pay costs that are eligible for forgiveness (payroll costs to retain employees; business mortgage interest 
                  payments; business rent or lease payments; or business utility  payments);
              •   includes all applicable reductions due to decreases in   the number of full-time equivalent employees and
                  salary/hourly wage reductions;
              •   includes payroll costs equal to at least 60% of the forgiveness amount;
              •        if a 24-week Covered Period applies, does not exceed  2.5 months’   worth of 2019 compensation for any owner-
                  employee or self-employed individual/general partner, capped at $20,833 per  individual; and
              •   if the Borrower has elected an 8-week Covered Period, does not exceed 8 weeks’ worth of 2019 compensation for
                  any owner-employee or self-employed individual/general partner, capped at $15,385 per individual.

          I understand that if the funds were knowingly used for unauthorized purposes, the federal government may pursue recovery 
          of loan amounts and/or civil or criminal fraud charges. 

          The Borrower has accurately verified the payments for the eligible payroll and nonpayroll costs for which the Borrower is 
          requesting forgiveness.  

          I have submitted to the Lender the required documentation verifying payroll costs, the existence of obligations and service 
          (as applicable) prior to February 15, 2020, and  eligible business mortgage interest payments, business rent or lease               
          payments, and business utility  payments.  

          The information provided in this   application and the information provided in all supporting documents and          forms is true  
          and correct in all material respects.     I understand that knowingly making a false statement to obtain forgiveness of         an 
          SBA-guaranteed loan is punishable under the law, including 18 U.S.C.  1001 and 3571 by imprisonment of not more than 
          five years and/or a fine of up to $250,000; under 15 U.S.C. 645 by imprisonment of not more than two years and/or a fine 
          of not more than $5,000; and, if submitted to a Federally insured institution, under 18 U.S.C.    1014 by    imprisonment of not 
          more than thirty years and/or a fine of not more than      $1,000,000. 

          The tax documents I   have submitted to the Lender are consistent with those  the Borrower has submitted/will submit                
          to the IRS and/or state tax or workforce agency. I also    understand, acknowledge, and agree that the Lender    can share          
          the tax information with SBA’s authorized representatives, including authorized representatives              of the SBA   Office of 
          Inspector General,   for the purpose of ensuring compliance with PPP requirements         and all SBAreviews.         

          I understand, acknowledge, and agree that SBA          may request additional information for the purposes of evaluating the        
          Borrower’s eligibility for the PPP  loan and for loan forgiveness, and that the Borrower’s failure      to   provide information    
          requested by SBA may result    in     a determination that the Borrower was ineligible for the PPP  loan or a denial   of the       
          Borrower’s loan forgiveness application.     
______   If the Borrower has   checked the box for FTE Reduction      Safe Harbor 1 on PPP Schedule A, the Borrower       was unable          
          to operate between February 15, 2020 and the           end of the Covered Period at   the same level of business activity as    
          before February 15,  2020    due to compliance with requirements  established or guidance issued between March 1, 2020 
          and December 31, 2020, by the Secretary of Health and Human Services, the Director of           the Centers for Disease Control 
          and Prevention, or the Occupational Safety and Health Administration, related to   the    maintenance   of standards   of sanitation, 
          social distancing, or any other work or customer safety requirement related to COVID-19.   

The Borrower’s eligibility for loan forgiveness will be evaluated in accordance with the PPP regulations and guidance issued by SBA 
through the date of this application. SBA may direct a lender to disapprove the Borrower’s loan forgiveness application if SBA 
determines that the Borrower was ineligible for the PPP loan. 

_____________________________________________________                                      ____________________________ 
Signature  of Authorized Representative    of  Borrower                                    Date  

_____________________________________________________                                      ____________________________ 
Print Name                                                                                 Title  

SBA Form 3508 (06/20) 
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Paycheck Protection Program OMB Control Number 3245-0407
Loan Forgiveness Application Revised June 16, 2020 Expiration Date: 1/2 31/202 3

PPP Schedule A

PPP Schedule A Worksheet, Table 1 Totals
Line 1. Enter Cash Compensation (Box 1) from PPP Schedule A Worksheet, Table 1:

Line 2. Enter Average FTE (Box 2) from PPP Schedule A Worksheet, Table 1:

Line 3. Enter Salary/Hourly Wage Reduction (Box 3) from PPP Schedule A Worksheet, Table 1:
If the average annual salary or hourly wage for each employee listed on the PPP
Schedule A Worksheet, Table 1 during the Covered Period or the Alternative Payroll
Covered Period was at least 75% of such employee’s average annual salary or hourly
wage between January 1, 2020 and March 31, 2020, check here ☐ and enter 0on line 3.

PPP Schedule A Worksheet, Table 2 Totals
Line 4. Enter Cash Compensation (Box 4) from PPP Schedule A Worksheet, Table 2:

Line 5. Enter Average FTE (Box 5) from PPP Schedule A Worksheet, Table 2:

Non-Cash Compensation Payroll Costs During the Covered Period or the Alternative Payroll Covered Period
Line 6. Total amount paid or incurred by Borrower for employer contributions for employee health insurance:

Line 7. Total amount paid or incurred by Borrower for employer contributions to employee retirementplans:

Line 8. Total amount paid or incurred by Borrower for employer state and local taxes assessed on employee
compensation:

Compensation to Owners
Line 9. Total amount paid to owner-employees/self-employed individual/general partners:
This amount may not be included in PPP Schedule A Worksheet, Table 1 or 2. If there is
more than one individual included, attach a separate table that lists the names of and
payments to each.

Total Payroll Costs
Line 10. Payroll Costs (add lines 1, 4, 6, 7, 8, and 9):

Full-Time Equivalency (FTE) Reduction Calculation
If you satisfy any of the following three criteria, check the appropriate box, skip lines 11 and 12, and enter 1.0 on line 13; otherwise,
complete lines 11, 12, and 13:

No reduction in employees or average paid hours: If you have not reduced the number of employees or the average paid hours of
your employees between January 1, 2020 and the end of the Covered Period, check here ☐.

FTE Reduction Safe Harbor 1: If you were unable to operate between February 15, 2020, and the end of the Covered Period at the
same level of business activity as before February 15, 2020 due to compliance with requirements established or guidance issued
between March 1, 2020 and December 31, 2020, by the Secretary of Health and Human Services, the Director of the Centers for Disease
Control and Prevention, or the Occupational Safety and Health Administration related to the maintenance of standards for sanitation,
social distancing, or any other worker or customer safety requirement related to COVID-19, check here ☐ .

FTE Reduction Safe Harbor 2: If you satisfy FTE Reduction Safe Harbor 2 (see PPP Schedule A Worksheet), check here ☐.

Line 11. Average FTE during the Borrower’s chosen reference period:

Line 12. Total Average FTE (add lines 2 and 5):

Line 13. FTE Reduction Quotient (divide line 12 by line 11) or enter 1.0 if any of the above criteria aremet: ___________________

SBA Form 3508 (06/20)
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Paycheck Protection Program OMB Control Number 3245-0407
Loan Forgiveness Application Revised June 16, 2020 Expiration Date: 12/31/202 3

PPP Schedule A Worksheet

Table 1: List employees who:
• Were employed by the Borrower at any point during the Covered Period or the Alternative Payroll Covered Period whose
principal place of residence is in the United States; and
• Received compensation from the Borrower at an annualized rate of less than or equal to $100,000 for all pay periods in
2019 or were not employed by the Borrower at any point in 2019.
Employee Salary / Hourly Wage
Employee's Name Identifier Cash Compensation Average FTE Reduction

FTE Reduction Exceptions:
Totals: Box 1 Box 2 Box 3

Table 2: List employees who:
• Were employed by the Borrower at any point during the Covered Period or the Alternative Payroll Covered Period whose
principal place of residence is in the United States; and
• Received compensation from the Borrower at an annualized rate of more than $100,000 for any pay period in 2019.
Employee
Employee's Name Identifier Cash Compensation Average FTE

Totals: Box 4 Box 5

Attach additional tables if additional rows are needed.

FTE Reduction Safe Harbor 2:

Step 1. Enter the borrower’s total average FTE between February 15, 2020 and April 26, 2020. Follow the same method that
was used to calculate Average FTE in the PPP Schedule A Worksheet Tables. Sum across all employees and enter:
.

Step 2. Enter the borrower’s total FTE in the Borrower’s pay period inclusive of February 15, 2020. Follow the same method
that was used in step 1: .

Step 3. If the entry for step 2 is greater than step 1, proceed to step 4. Otherwise, FTE Reduction Safe Harbor 2 is not
applicable and the Borrower must complete line 13 of PPP Schedule A by dividing line 12 by line 11 of that schedule.

Step 4. Enter the borrower’s total FTE as of the earlier of December 31, 2020, and the date this application is submitted: .

Step 5. If the entry for step 4 is greater than or equal to step 2, enter 1.0 on line 13 of PPP Schedule A; the FTE Reduction Safe
Harbor 2 has been satisfied. Otherwise, FTE Reduction Safe Harbor 2 does not apply and the Borrower must complete
line 13 of PPP Schedule A by dividing line 12 by line 11 of that schedule.

SBA Form 3508 (06/20)

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Paycheck Protection Program OMB Control Number 3245-0407
Loan Forgiveness Application Revised June 16, 2020 Expiration Date: 12/31/202 3

PPP Borrower Demographic Information Form (Optional)

Instructions

1. Purpose. Veteran/gender/race/ethnicity data is collected for program reporting purposes only.
2. Description. This form requests information about each of the Borrower’s Principals. Add additional sheets if necessary.
3. Definition of Principal. The term “Principal” means:
• For a self-employed individual, independent contractor, or a sole proprietor, the self-employed individual, independent
contractor, or sole proprietor.
• For a partnership, all general partners and all limited partners owning 20% or more of the equity of the Borrower, or any
partner that is involved in the management of the Borrower’s business.
• For a corporation, all owners of 20% or more of the Borrower, and each officer and director.
• For a limited liability company, all members owning 20% or more of the Borrower, and each officer and director.
• Any individual hired by the Borrower to manage the day-to-day operations of the Borrower (“key employee”).
• Any trustor (if the Borrower is owned by a trust).
• For a nonprofit organization, the officers and directors of the Borrower.
4. Principal Name . Insert the full name of the Principal.
5. Position. Identify the Principal’s position; for example, self-employed individual; independent contractor; sole proprietor;
general partner; owner; officer; director; member; or key employee.

Principal Name Position

Veteran 1=Non-Veteran; 2=Veteran; 3=Service-Disabled Veteran; 4=Spouse of Veteran; X=Not
Disclosed
Gender M=Male; F=Female; X=Not Disclosed
Race (more than 1 1=American Indian or Alaska Native; 2=Asian; 3=Black or African-American; 4=Native
may be selected) Hawaiian or Pacific Islander; 5=White; X=Not Disclosed
Ethnicity H=Hispanic or Latino; N=Not Hispanic or Latino; X=Not Disclosed

Disclosure is voluntary and will have no bearing on the loan forgiveness decision

Paperwork Reduction Act – You are not required to respond to this collection of information unless it displays a currently valid OMB Control
Number. The estimated time for completing this application, including gathering data needed, is 180 minutes. Comments about this time or the
information requested should be sent to Small Business Administration, Director, Records Management Division, 409 3rd St., SW, Washington DC
20416, and/or SBA Desk Officer, Office of Management and Budget, New Executive Office Building, Washington DC 20503. PLEASE DO
NOT SEND FORMS TO THESE ADDRESSES.

SBA Form 3508 (06/20)

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