PDF document
- 1 -
                                                                                                                                       OMB Control No.: 3245-0407  
                                                                                                                                       Expiration Date:  01/31/2022   
                                                    Paycheck Protection Program 
                             PPP Loan Forgiveness Application Form 3508EZ Revised July 30, 2021 
                                                                                                                                                          
                        Business Legal Name (“Borrower”)                                          DBA or Tradename, if applicable 
                                                                                     
                         Business Address                               NAICS Code  Business TIN (EIN, SSN, ITIN)                   Business Phone 
                                                                                                                    (                ) -
                                                                                         Primary Contact                            E-mail Address First Draw PPP LoanSecond Draw PPP Loan  (check one) 

SBA PPP Loan Number:  ________________________                      Lender PPP Loan Number: __________________________ 

PPP Loan Amount:  _____________________________                     PPP Loan Disbursement Date:  ________________________ 
Amount of PPP Loan Increase   (if applicable): ___________            Date   of PPP Loan Increase   (if applicable):_______________                      

Employees   atTime of   Loan Application:     ___________           Employees   atTime of   Forgiveness Application:                  __________ 

Covered  Period:   ________________________ to ________________________  

Forgiveness Amount Calculation: 

Payroll and Nonpayroll  Costs  
Line 1.  Payroll Costs:                                                                                  _____________________ 

Line 2.  Business Mortgage    Interest Payments:                                                         _____________________ 

Line 3.  Business Rent  or Lease Payments:                                                               _____________________ 

Line 4.  Business Utility  Payments:                                                                     _____________________ 

Line 5.  Covered Operations    Expenditures:                                                             _____________________ 

Line 6.  Covered Property  Damage Costs:                                                                 _____________________ 

Line 7.  Covered Supplier   Costs:                                                                       _____________________ 

Line 8.  Covered Worker Protection Expenditures:                                                         _____________________ 

Potential Forgiveness Amounts 
Line 9.  Sum the  amounts   on lines   1 through 8:                                                      _____________________ 

Line 10. PPP Loan Amount:                                                                                _____________________ 

Line 11.  Payroll Cost 60%   Requirement (divide    Line   1  by 0.60):                                  _____________________ 

Forgiveness Amount 
Line 12. Forgiveness Amount (enter     the smallest   of Lines   9, 10, and 11):                         _____________________ 

SBA Form 3508EZ (07/21)                                        
Page 1 



- 2 -
                                                                                                                                    OMB Control No.: 3245-0407 
                                                                                                                                     Expiration Date: 01/31/2022  
                                                      Paycheck Protection Program 
                               PPP Loan Forgiveness Application Form               3508EZ     Revised July 30,    2021 

                                         PPP Borrower Demographic Information (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   necessary.if 
     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.   Principal 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                                                                  Principal Position 
                                                                                   
                       Select Response Below:                                                                                     

   Veteran             □ Non-Veteran;  □Veteran;  Service-Disabled □        Veteran;     Spouse □ of Veteran;  Not □              
                       Disclosed 
   Gender              □ Male;  □Female;  Not □   Disclosed                                                                       
   Race (more than 1   □ American Indian or       Alaska Native;  □Asian;  Black □       or   African-American;  Native □         
   may be selected)    Hawaiian   or Pacific Islander;  □White;  Not □ Disclosed            
   Ethnicity           □ Hispanic   or Latino;  □Not Hispanic   or Latino;  □Not Disclosed                                        
 
                           Disclosure is voluntary and will have no bearing on the loan forgiveness decision 
  
 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   byinitialing next to each one.       The terms “payroll” and 
 “payroll costs”   as used in the below certifications include proprietor expenses (business         expenses    plus owner compensation)  for 
 Borrowers that applied for loans using SBA Form         2483-C   or 2483-SD-C. 
  
 _____    The dollar amount for which forgiveness   is requested       (which does       not exceed the   principal amount   of the PPP loan): 
               •      was used to pay business    costs that are eligible for   forgiveness (payroll costs   to retain employees;   business mortgage 
                      interest payments; business rent or lease payments; business utility payments;            covered   operations expenditures;      
                      covered property damage costs; covered supplier         costs;   or covered worker protection expenditures); 
               •      includes payroll costs equal     to at least 60%   of the forgiveness   amount;  and 
               •      for any owner-employee      (with  an ownership  stake    of 5% or more)    or self-employed individual/general partner,         does 
                      not exceed 2.5 months’ worth of compensation          received     during the year  used to calculate the PPP loan amount,        
                      capped   at$20,833 per individual  in   total across  all   businesses.  
 _____       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 did not reduce salaries   or hourly         wages   of any employee    by more     than 25 percent for any employee during the 
          Covered Period compared   to the most recent quarter before the Covered Period.  For purposes   of this certification, the term 
          “employee” includes only those employees that did not receive, during any single period during                  2019, wages   or salary at   an 
          annualized rate   of pay in an amount more than $100,000. 
 _____    The Borrower has accurately verified the payments for the eligible payroll and nonpayroll costs for                which the Borrower is      
          requesting forgiveness.  

SBA Form 3508EZ (07/21)                                           
Page 2 
 



- 3 -
                                                                                                                               OMB Control No.: 3245-0407 
                                                                                                                                  Expiration Date: 01/31/2022 
                                                      Paycheck Protection Program 
                              PPP Loan Forgiveness Application Form               3508EZ  Revised   July 30,  2021 

_____     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, 
          business utility payments,  covered operations expenditures, covered         property damage costs,      covered supplier costs, and     
          covered worker protection expenditures.   
_____          If this application   is being submitted for   a Second Draw    PPP Loan,  the Borrower    used all First Draw PPP Loan    amounts on 
          eligible expenses prior to disbursement of     the    Second Draw    PPP Loan. 
_____    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   ispunishable under the     law, including   18 U.S.C. 1001 and 3571 by imprisonment   of not      more than five years 
          and/or   afine 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         (if applicable) are consistent   with  those  the Borrower has submitted        
          or 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 SBA 
          reviews. 
_____         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.  

In addition, the Authorized Representative   of the Borrower must certify byinitialing at least ONE   of the           following  two items: 
_____       The Borrower did not reduce the       number   of employees   or the average  paid hours   of employees  between  January 1,  2020 and 
            the end of the Covered  Period        (other than any  reductions that arose from an inability to  rehire individuals  who    were     
            employees on February 15, 2020,   if the Borrower was unable   to hire similarly        qualified employees for unfilled positions   on 
            or before December 31,      2020 (or, for a PPP loan  made after   December   27, 2020, before    the last day of the Covered Period), 
            and reductions in an employee’s hours that   a borrower offered to restore      and were   refused). 
_____     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 (or,            for a   PPP loan made after December 27, 2020, requirements     established  or      
          guidance issued before the last day of the Covered Period), 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   ofAuthorized Representative of   Borrower                                               Date 

_____________________________________________________                                               ____________________________  
Print Name                                                                                          Title 

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 20 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 3508EZ (07/21) 
Page 3 



- 4 -
                                                                                                                                           OMB Control No.: 3245-0407 
                                                       Paycheck Protection Program                                                           Expiration Date: 01/31/2022 
                                  PPP Loan Forgiveness Application          Form 3508EZ         Revised  July 30,   2021 

                         PPP LOAN  FORGIVENESS  PPLICATION A         ORM F       3508EZ    INSTRUCTIONS FOR  BORROWERS               
                                                                             
                                                   Checklist   for Using   SBA   Form   3508EZ   
 
You (the Borrower)        can apply for forgiveness   of your First   or Second Draw       Paycheck Protection Program (PPP)            Loan using this 
SBA Form 3508EZ if your PPP loan amount   is more than               $150,000 and     you can   check   at least one   of the two boxes    below.   If 
your loan amount   is $150,000   or less, please use SBA Form        3508S.      Do not    submit this Checklist with     your SBA      Form 3508EZ.    
Each PPP loan must use   a separate loan forgiveness          application form.     You cannot   use  one  form to apply  for   forgiveness   of both a 
First Draw PPP Loan         and a Second Draw PPP loan.   For   a Second Draw PPP           Loan in excess   of $150,000,     you must     submit   a loan 
forgiveness application for your First Draw PPP Loan before   or simultaneously with the                loan forgiveness      application  for your 
Second Draw PPP Loan, even if the calculated amount   of forgiveness on your                First Draw PPP Loan is        zero. 
 
       ☐    The Borrower     did not reduce annual    salary   or hourly wages   of any employee by      more    than 25  percent   during  the Covered 
            Period compared to    the most recent full quarter       before the Covered    Period. (For  purposes   of this   statement,   “employees” 
            means only those employees that        did not receive, during any single period during        2019, wages   or salary at    an annualized 
            rate   of pay in   an amount more than $100,000.); 
                                                                            AND   
            The Borrower did not reduce the number   of employees   or the average             paid hours   of employees between        January 1, 2020 
            and the end of the Covered Period.  
                         •     Ignore reductions that arose from an inability       to rehire  individuals who were employees           on February   15, 
                               2020   if the Borrower was unable   to hire similarly qualified employees         for unfilled positions   on or before 
                               December 31, 2020 (or,     for a PPP loan    made    after December 27, 2020, the last     day of the    Covered 
                               Period).    
                         •     Also ignore reductions in an employee’s hours that          the Borrower offered to restore    and the    employee 
                               refused.   See   85 FR 33004  , 33007     (June   1, 2020) for  more details. 
                      ----------------------------------------------------------------------------------------------------------------- 
       ☐    The Borrower did not reduce annual salary   or hourly wages   of any employee by more                than 25 percent    during the Covered 
            Period compared to the most recent full       quarter    before the Covered    Period.  (For purposes   of this   statement,   “employees” 
            means only those      employees that did not receive, during any single period during          2019, wages   or salary at    an annualized 
            rate   ofpay in an amount more   than  $100,000,);       
                                                                            AND  
            The Borrower was unable to operate during         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 (or, for a PPP loan made after December 27,         2020,   requirements      established or guidance    issued  between    March 1, 
            2020 and the last day of the Covered Period) 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   ofsanitation, social distancing,  or   any other work or customer      safety requirement related     to COVID-19.       
 
If you can check   atleast one    of   the two boxes  above,  complete   this SBA     Form 3508EZ   in   accordance with the     instructions   below,     
and submit     it toyour Lender      (or the Lender that   is servicing your     loan).  Borrowers may also complete this application 
electronically through their Lender.     If your loan   is for more than $150,000 and you           are unable   to check one   of the  boxes  above, 
you cannot use SBA Form 3508EZ and instead you must apply for                   forgiveness   of your PPP loan using      SBA   Form 3508.  
 
   If this  application   is being submitted   for a First Draw PPP      Loan   approved   on or before    August   8, 2020   and  the Borrower   is 
required   tosubmit an SBA        Form 3508D   disclosure  of     a controlling interest, that disclosure  must  be   submitted to   the Lender not      
later than 30 days after submission   of this loan forgiveness       application. See subsection B.16   of SBA’s          interim final  rule  posted   on 
January   6,2021 (86     FR 3692).   

                                    Instructions for PPP Loan Forgiveness             Calculation   Form 3508EZ 
                                                                             
Business Legal Name (“Borrower”)/DBA   or Tradename   (if applicable)/Business                      TIN (EIN, SSN,        ITIN):  Enter    the same 
information   ason your Borrower       Application Form    (SBA      Form 2483,  SBA     Form   2483-SD,   SBA   Form     2483-C,   SBA Form    2483- 
SD-C,   orlender’s equivalent).      
 
Business Address/NAICS Code/Business Phone/Primary                   Contact/E-mail        Address:  Enter the same information   as on your 
Borrower Application Form, unless there has been a change   in address   or contact information.  If NAICS Code was not   on the 
Borrower Application Form, match the           business activity code provided on IRS          income tax filings,   if applicable. 
 
SBA Form 3508EZ (07/21)                                              
Page 1 



- 5 -
                                                      Paycheck Protection Program                                                   OMB Control No.: 3245-0407 
                                                                                                                                     Expiration Date:  01/31/2022  
                                 PPP Loan Forgiveness Application Form          3508EZ   Revised   July 30,  2021 
                                                                                                                                                       
 First Draw PPP Loan or Second Draw PPP Loan:  Select the box that describes the PPP loan                    that this forgiveness  application   is 
 for.     If you only have    one PPP loan, select First Draw  PPP  Loan. 

 SBA PPP Loan Number:  Enter the loan number assigned by SBA   at the               time of loan approval.  Request this number         from the 
 Lender   necessary.if    
  
 Lender PPP Loan Number:  Enter the           loan number assigned to     the PPP  loan by the Lender. 
  
 PPP Loan Amount:  Enter the original disbursed principal amount of the PPP loan (the original               loan amount you      received from 
 the Lender). 
  
 PPP Loan Disbursement Date:  Enter the date that you            received the PPP loan   proceeds from    the Lender.     If loan proceeds   were 
 received on more    than one date, enter the first date   on which you received PPP    loan  proceeds.   If you received an authorized increase 
 on your First Draw      PPP Loan after December 27, 2020, you must       enter the date   on which you received the     original   disbursement of 
 your PPP loan proceeds.  
  
 Amount of PPP Loan         Increase:  Enter the disbursed amount   of an authorized increase on your        First Draw PPP Loan received 
 after December 27, 2020 (if applicable). 

 Date   ofPPP Loan    Increase:      Enter the date that you received the proceeds   of the authorized    increase on    your First Draw   PPP 
 Loan from the Lender   (if applicable). 

 Employees   atTime of   Loan Application:         Enter the total number   of employees (including     owners/partners)   at the time   of the 
 PPP loan application. 
  
 Employees   atTime of   Forgiveness Application:         Enter the total number   of employees   (including owners/partners)   at the     time the 
 Borrower is applying for loan forgiveness. 
  
 Covered Period:  The Covered Period begins         on the date the loan  was   originally disbursed.     It ends   on a date selected  by the 
 Borrower that     is at least 8 weeks following the date   of loan disbursement   and not more   than 24 weeks    after the  date   of loan 
 disbursement.  For example,   if the Borrower received their PPP     loan proceeds on Monday, April         20, 2020,   the  first day of the 
 Covered Period is Monday, April 20, 2020 and the final day of        the Covered   Period   is any date  selected by the    Borrower   between 
 Sunday, June 14, 2020 and Sunday, October 4, 2020. 
  
 Forgiveness Amount Calculation (see Summary   of Costs Eligible for Forgiveness below): 
  
 Line 1:  Enter total eligible payroll costs incurred   or paid during the Covered     Period.  To calculate these     costs, add the following: 
  
          Cash Compensation:  The sum   of gross salary, gross wages, gross tips, gross       commissions, paid leave      (vacation,   family, 
          medical   orsick leave, not including leave covered  by the Families  First Coronavirus   Response     Act),   and  allowances for    
          dismissal or separation paid   or incurred during the  Covered Period.  Do not include qualified       wages taken into account in 
          determining (a) the Employee Retention Credit under section 2301   of the CARES         Act,   as amended by sections 206        and 207 
          of the Taxpayer Certainty and Disaster    Tax  Relief  Act   of 2020; (b) the Employee  Retention Credit       under section  3134 of  the 
          Internal Revenue Code   of 1986,   as enacted   by the American Rescue Plan Act   of 2021; and (c)      the  disaster credit  under 
          section 303   ofthe Taxpayer Certainty  and Disaster Tax  Relief Act  of   2020.    For each individual employee, the total amount 
          of cash compensation eligible for    forgiveness may not exceed an annual     salary of $100,000,   as prorated for     the Covered 
          Period.  For example, for an 8-week    Covered Period, the maximum   is $15,385,      for   a 24-week  Covered     Period, the 
          maximum   $46,154.is      You can only include compensation of employees       who were employed by          the Borrower   at any point 
          during the Covered Period and whose principal place   of residence is in      the United States. 
  
          Employee Benefits:  The total amount      paid by the  Borrower for: 
             1.  Employer       contributions for employee   group health, life, disability, vision,   or dental insurance, including   employer 
                   contributions to a self-insured, employer-sponsored     group health plan,   but excluding any pre-tax   or after-tax 
                   contributions by employees. Do not add contributions       for  these benefits made on behalf     of a self-employed 
                   individual, general partners, or owner-employees     of an S-corporation,    because such payments        are already included 
                   in their compensation.  Additionally, do not add premiums        for COBRA continuation coverage taken into account   in 
                   determining the credit under section 6432   of the     Internal Revenue Code   of 1986. 
                                        
SBA Form 3508EZ (07/21)                                         
Page 2 
 



- 6 -
                                                       Paycheck Protection Program                                                   OMB Control No.: 3245-0407 
                                                                                                                                       Expiration Date:  01/31/2022  
                             PPP Loan Forgiveness Application Form                3508EZ   Revised   July 30,  2021 
                                                                                                                                                         
             2.  Employer   contributions to employee       retirement plans, excluding    any pre-tax   or after-tax contributions    by 
                 employees. Do not add employer         retirement contributions    made on behalf     of a self-employed individual   or general 
                 partners, because such payments are already included in their          compensation. 
             3.  Employer   state and local taxes paid by       the borrower and    assessed on employee       compensation (e.g.,   state 
                 unemployment insurance tax), excluding any taxes           withheld from employee     earnings. 
  
       Owner Compensation:  Any amounts paid to owners (owner-employees (with an ownership stake   of 5%   or more),   a self-
       employed individual, or general partners).  For each individual owner in total across   all businesses,            this amount   is capped at 
       (a) $20,833 (the 2.5-month equivalent   of $100,000 per        year),   or (b) the 2.5-month equivalent   of the   individual’s  applicable 
       compensation in the year that was used to calculate the loan         amount (2019 or 2020), whichever   is lower.       If Borrower 
       applied for the loan using SBA Form        2483-C   or 2483-SD-C, owner        compensation   includes  proprietor expenses     (business 
       expenses plus owner compensation).  Proprietor expenses equal the difference between the                Borrower’s     gross  income   and 
       employee payroll costs.  The Borrower’s proprietor expenses           are capped   at (a) $20,833 (the      2.5-month  equivalent   of 
       $100,000 per year),   or (b) the 2.5-month equivalent   of the borrower’s gross income in the           year that was   used to calculate    the 
       loan amount (2019 or 2020), whichever   is lower. 
        
 Line 2:  Enter the amount   of business    mortgage interest payments paid or      incurred during the Covered Period for         any business 
 mortgage obligation on real   or personal property in force before February        15, 2020.  Do not include prepayments. 
  
 Line 3:  Enter the amount   of business    rent   or lease payments paid or incurred for  real   or personal  property during the Covered 
 Period, pursuant to lease agreements   in force before February 15,        2020.  
  
 Line 4:  Enter the amount   of business utility payments paid   or incurred during the Covered Period for          business   utilities for which 
 service began before February 15, 2020.   
  
 Line 5:  Enter the amount   of covered operations expenditures       paid or incurred during    the Covered       Period.  
  
 Line 6:  Enter the amount   of covered property damage costs paid or incurred during the Covered              Period. 
  
 Line 7:  Enter the amount   of covered supplier      costs paid or incurred during the Covered Period pursuant          to a contract, order,   or 
 purchase order in effect prior to the beginning of     the Covered Period    (for perishable  goods,  the     contract, order,   or purchase order 
 shall have been in effect before     or at any time  during the Covered Period). 
  
 Line 8: Enter the amount   of covered worker protection expenditures        paid or incurred during the       Covered Period. 
  
 NOTE:  For lines 2-8, you are   not required to report payments that you do not want to include   in the forgiveness              amount. 
  
 Line 9:  Add lines 1 through   8 enter the total.    
  
 Line 10:  Enter the PPP Loan Amount.   
  
 Line 11: Divide the amount   on line 1 by 0.60,       and  enter the amount.  This determines whether   at least 60%   of the       potential 
 forgiveness amount was used for payroll costs.   
 
 Line 12:  Enter the smallest   of lines   9, 10, or 11.   
  
 Summary   ofCosts Eligible   for  Forgiveness:        
  
 Borrowers are eligible  for loan forgiveness for the following       costs: 
  1.   Eligible payroll costs.  Borrowers are generally eligible for forgiveness          for the payroll costs paid and payroll     costs incurred 
       during the Covered Period (“payroll        costs”).  Payroll costs are considered paid on the day that      paychecks are     distributed   or 
       the Borrower originates   an ACH credit transaction.  Payroll costs are considered incurred on the day that             the employee’s 
       pay   earned.is   Payroll costs incurred   but not paid during  the   Borrower’s   last pay period of   the Covered    Period   are eligible 
       for forgiveness   ifpaid on or before the  next    regular payroll date.     Otherwise, payroll costs must   be paid during the Covered 
       Period.  For each individual   employee,       the total amount   of cash compensation eligible for     forgiveness  may not    exceed an 
       annual salary of $100,000,   as prorated for the Covered Period.  Count payroll costs that were both paid and incurred only 
       once.  Include only payroll costs for employees       whose principal      place of residence     is in the United States.  For information 
       on what qualifies   as payroll costs, see SBA’s interim      final rule posted on January 6,  2021 (86 FR    3692),   as amended by 
       SBA’s interim final rule posted on March 18, 2021          (86 FR 15083).  For information on what qualifies   as payroll costs         for   a 
       Borrower that applied for the loan using        SBA  Form 2483-C   or 2483-SD-C,      see SBA’s interim     final rule  on loan amount 
SBA Form 3508EZ (07/21)                                          
Page 3 
 



- 7 -
                                                            Paycheck Protection Program                                                    OMB Control No.: 3245-0407 
                                                                                                                                              Expiration Date:  01/31/2022  
                                   PPP Loan Forgiveness Application Form               3508EZ     Revised   July 30, 2021 
                                                                                                                                                                
       calculation and eligibility posted on March 3, 2021              (86 FR 13149),     as amended by    SBA’s   interim final rule posted     on 
       March 18, 2021 (86 FR 15083).   
 
   2.  Eligible nonpayroll costs.  Nonpayroll costs eligible for forgiveness consist               of:  
               (a) covered mortgage obligations: payments   of mortgage          interest    (not including  any prepayment or payment   of principal) 
               on any business mortgage obligation on real   or personal property incurred              before February 15, 2020      (“business  mortgage 
               interest payments”); 
               (b) covered rent obligations: business rent or lease       payments       pursuant to lease agreements     for real or personal property   in 
               force before February 15, 2020 (“business rent   or lease payments”);  
               (c) covered utility payments: business payments for   a service           for the  distribution   of electricity, gas, water, 
               telephone, transportation, or internet access for which service began           before   February 15, 2020     (“business   utility 
               payments”); 
               (d) covered operations expenditures:         payments    for any business software   or cloud   computing    service that   facilitates 
               business operations, product   or service delivery, the processing, payment,   or tracking of payroll expenses,               human 
               resources, sales and billing functions,   or accounting of tracking of         supplies,  inventory, records, and expenses; 
               (e) covered property damage           costs: costs related to property damage      and vandalism or looting due   to public    disturbances 
               that occurred during 2020 that were not        covered   by insurance   or other compensation;  
               (f) covered supplier costs: expenditures made to a supplier   of goods          for the supply of    goods   that are essential   to the 
               operations of the Borrower at the time   at which the         expenditure   is made, and made pursuant to a       contract, order,   or 
               purchase order in effect prior to the beginning of the Covered Period (for             perishable goods, the      contract, order, or 
               purchase order may have been in effect before     or at any time during the         Covered Period);     and 
               (g) covered worker protection expenditures: operating   or capital          expenditures     that facilitate the adaptation   of the business 
               activities     ofentityan to   comply with the requirements   established   or   guidance issued  by the Department    of   Health and     
               Human Services, the Centers for       Disease Control,   or the Occupational Safety and Health           Administration,   or any  
               equivalent requirements        established or guidance issued    by   a State   or local government, during    the period starting March 
               1, 2020 and ending on the date on which the        national emergency         declared   by the President with    respect  to the 
               Coronavirus Disease 2019 (COVID-19) expires related to                 maintenance standards    for sanitation,   social distancing,   or any 
               other worker or customer safety requirement related   to COVID-19, but does not include residential real property or 
               intangible property.   
        
       Eligible nonpayroll costs cannot exceed 40%   of the total forgiveness amount.  An eligible                  nonpayroll   cost either must   be paid 
       during the Covered Period or incurred during the Covered Period and paid on   or before                   the next   regular   billing date, even if 
       the billing date   is after the Covered Period.        Count nonpayroll costs that      were both paid and    incurred only once. 
 
               Documents that Each Borrower Must Submit with   its PPP Loan Forgiveness                       Application Form 3508EZ 

PPP Loan Forgiveness Calculation Form                3508EZ 
 
Payroll:  Documentation verifying the eligible       cash compensation and non-cash            benefit payments     from  the Covered Period consisting 
of each   of the following: 
   a.  Bank account        statements   or third-party payroll    service provider     reports documenting    the   amount   of cash compensation    paid 
       to employees. 
   b.  Tax forms       (or equivalent third-party payroll service provider reports) for the        periods    that  overlap with the  Covered     Period:  
               i.   Payroll tax filings reported,   or that   will   be reported,   to the IRS (typically,  Form    941); and 
               ii.  State  quarterly business and individual employee        wage reporting and       unemployment      insurance     tax filings reported, 
                    or that will   be reported,   to the relevant state. 
   c.  Payment       receipts, cancelled   checks,   or account statements documenting the        amount   of any employer contributions         to 
       employee group health, life, disability, vision   or dental        insurance      and retirement plans  that the Borrower      included   in the 
       forgiveness amount. 
   d.          If you checked   only the   first box on the   checklist on page     1 of these instructions,  the average number      of full-time equivalent 
       employees on payroll employed by the Borrower on January 1,                    2020 and at the   end of the Covered Period. 
                     
Nonpayroll:  For categories a-c, documentation            verifying existence   of the obligations/services prior     to February     15, 2020 and,  for all 
categories, eligible payments      from    the Covered Period. 
   a.  Business      mortgage interest payments:     Copy of lender amortization schedule and            receipts   or cancelled checks    verifying 
       eligible payments from the Covered Period;   or lender account              statements from February 2020 and        the months   of the     Covered 
       Period through one month after the            end of the Covered Period verifying interest        amounts    and eligible payments. 
   b.  Business      rent   or lease payments: Copy   of current  lease agreement        and  receipts   or cancelled checks  verifying   eligible 
       payments from the Covered           Period;   or lessor account statements from February 2020 and from the             Covered     Period  through 
       one month after      the end of the Covered Period verifying eligible           payments.  

SBA Form 3508EZ (07/21)                                            
Page 4 
 



- 8 -
                                                     Paycheck Protection Program                                                    OMB Control No.: 3245-0407 
                                                                                                                                     Expiration Date:  01/31/2022  
                                 PPP Loan Forgiveness Application Form        3508EZ       Revised   July 30,   2021 
                                                                                                                                                       
     c.  Business  utility payments: Copy of invoices    from  February 2020 and      those   paid during the   Covered Period and    receipts, 
          cancelled checks, or account   statements verifying  those eligible payments. 
     d.  Covered   operations expenditures: Copy of invoices, orders,   or purchase orders       paid during the   Covered Period and receipts, 
          cancelled checks, or account   statements verifying  those eligible payments. 
     e.  Covered   property damage costs: Copy of invoices, orders,   or purchase      orders paid during    the Covered    Period  and receipts, 
          cancelled checks, or account   statements verifying  those eligible payments, and documentation that          the costs were related   to 
          property damage and vandalism   or looting due   to public   disturbances that   occurred during 2020 and       such costs were  not 
          covered by insurance or other compensation. 
     f.  Covered   supplier costs: Copy of contracts, orders,   or purchase orders   in effect   at any time before    the Covered  Period (except 
          for perishable goods), copy of   invoices, orders, or purchase   orders paid during    the Covered    Period  and receipts, cancelled 
          checks,   oraccount statements verifying those eligible payments.    
     g.  Covered   worker protection expenditures: Copy   of invoices, orders,   or purchase     orders  paid during the    Covered Period and 
          receipts, cancelled checks,   or account statements verifying those    eligible payments,      and documentation that   the expenditures 
          were used by the Borrower   to comply with  applicable COVID-19 guidance            during the Covered Period. 
 
                             Documents that Each Borrower Must Maintain but   is Not Required                to Submit 

Documentation supporting the certification that annual salaries   or hourly wages were         not reduced by   more   than 25 percent during   the 
Covered Period relative   to the most recent full quarter before  the Covered Period.  This documentation must include payroll records 
that separately list each employee and show the    amounts paid to each     employee during      the most  recent  full quarter before the 
Covered Period, and the amounts paid to each employee        during the Covered       Period.  
 
Documentation regarding any employee job offers and refusals, refusals   to accept restoration of          reductions   in hours, firings for cause, 
voluntary resignations, written requests   by any  employee for reductions in work        schedule, and  any inability   to hire similarly qualified 
employees for unfilled positions on or before    December   31,   2020 (or, for a PPP loan     made  after December 27, 2020,     the last day of 
the  Covered Period).  
 
Documentation supporting the certification,   if applicable, that    the Borrower did not    reduce the  number   of employees   or the  average 
paid hours   ofemployees between     January 1, 2020 and the end  of   the Covered    Period, other than any reductions that    arose from an   
inability to rehire individuals   who were employees on February 15,       2020,   if the Borrower was unable   to hire   similarly qualified 
employees for unfilled positions   on or before  December 31,     2020 (or, for a PPP loan     made  after December 27,     2020, the last day  of 
the Covered Period).  This documentation must include payroll        records that separately list each employee      and show    the amounts  paid 
to each employee between January 1,      2020 and the end of  the   Covered  Period.  
 
Documentation supporting the certification,   if applicable, that 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   orguidance issued  between March 1, 2020   and December 31,    2020     (or, for a PPP loan    made  after December 27, 2020,      
requirements established   or guidance issued between March 1, 2020 the last          day of the Covered   Period) 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.  This documentation must include copies   of the        applicable    requirements for   each borrower  location 
and relevant borrower financial records. 
 
All records relating   to the Borrower’s PPP loan,   including documentation     submitted    with   its PPP loan  application, documentation 
supporting the Borrower’s certifications as   to the necessity   of the loan request and   its eligibility for   a PPP loan (including the 
Borrower’s gross receipt reduction certification for   a Second Draw PPP Loan,   if applicable),         documentation necessary    to support  the 
Borrower’s loan forgiveness application,     and documentation    demonstrating the Borrower’s material         compliance   with PPP 
requirements.    
 
Records Retention Requirement: The Borrower must retain   all such documentation     in its files          for six years  after the date the loan is 
forgiven or repaid   infull, and permit authorized representatives of   SBA, including    representatives of its   Office of Inspector General,     
to access such files upon request.  The Borrower must provide documentation independently to a lender              to satisfy relevant Federal, 
State, local   or other statutory or regulatory requirements   or in connection with an SBA loan     review   or audit.  
 
SBA Form 3508EZ (07/21)                                       
Page 5 
 






PDF file checksum: 2181136325

(Plugin #1/9.12/13.0)