Common use of Additional Information Required Clause in Contracts

Additional Information Required. OWNERSHIP (%): Male Female RACE: (Voluntary) American Indian or Alaska Native Asian Black or African-American Native Hawaiian or Pacific Islander White ETHNICITY (Voluntary) Hispanic or Latino VETERAN STATUS: Veteran Non-Veteran Primary Business Activity: NAICS Annual Sales in Last Fiscal Year: Year Business Established: Total Full Time Employees (2 half time employees equals 1 full time employee): Estimated Jobs Created by this Loan over next 3 years: Estimated Jobs Retained by this Loan over next 3 years: Does the Borrower, including any parent or subsidiary or affiliated entity, in Virginia: have 250 or fewer employees? Yes No Current # OR have less than $10,000,000 in annual gross revenues over each of the last three (3) fiscal years? Yes No OR have less than $2,000,000 in net worth? Yes No If the answer to any of the following questions is “yes”, please furnish details on an attached sheet. Have any owners, officers, directors, guarantors, general partners, stockholders or limited partners owning 20% or more of the Borrower ever been charged with, or convicted of, any criminal offense, other than minor motor vehicle violations? Yes No Has the Borrower or management of the Borrower been informed of any current or on-going investigation of the Borrower with respect to possible violations of state or federal securities laws? Yes No Has the Borrower or any owners, officers, directors, guarantors, general partners, stockholders of limited partners owning 20% or more of the Borrower been in receivership or adjudicated as bankrupt? Yes No Is the Borrower or any of its owners, officers, directors, guarantors, general partners, stockholders or limited partners owning 20% or more of the Borrower involved in any pending lawsuits? Yes No Does the Borrower or any guarantors owe past due federal, state or local taxes of any nature? Yes No

Additional Information Required. OWNERSHIP (%): Male Female RACE: (Voluntary) American Indian or Alaska Native Asian Black or African-American Native Hawaiian or Pacific Islander White ETHNICITY (Voluntary) Hispanic or Latino Latino‌ VETERAN STATUS: Veteran Non-Veteran Primary Business Activity: NAICS Annual Sales in Last Fiscal Year: Year Business Established: Total Full Time Employees (2 half time employees equals 1 full time employee): Estimated Jobs Created by this Loan over next 3 years: Estimated Jobs Retained by this Loan over next 3 years: Does the Borrower, including any parent or subsidiary or affiliated entity, in Virginia: have 250 or fewer employees? Yes No Current # OR have less than $10,000,000 in annual gross revenues over each of the last three (3) fiscal years? Yes No OR have less than $2,000,000 in net worth? Yes No If the answer to any of the following questions is “yes”, please furnish details on an attached sheet. Have any owners, officers, directors, guarantors, general partners, stockholders or limited partners owning 20% or more of the Borrower ever been charged with, or convicted of, any criminal offense, other than minor motor vehicle violations? Yes No Has the Borrower or management of the Borrower been informed of any current or on-going investigation of the Borrower with respect to possible violations of state or federal securities laws? Yes No Has the Borrower or any owners, officers, directors, guarantors, general partners, stockholders of limited partners owning 20% or more of the Borrower been in receivership or adjudicated as bankrupt? Yes No Is the Borrower or any of its owners, officers, directors, guarantors, general partners, stockholders or limited partners owning 20% or more of the Borrower involved in any pending lawsuits? Yes No Does the Borrower or any guarantors owe past due federal, state or local taxes of any nature? Yes No