Treasury Department Form: TD F 102.5 (05/ϯϭ/11) 1 OMB Number 1505-0232

Application Instructions

For Community Development Loan Funds

To apply for funding from the Small Business Lending Fund (SBLF), your Community Development Loan Fund (CDLF) must 

submit a completed version of the attached application and a small business lending plan to the U.S. Department of the 

Treasury (Treasury) via email at CDLFApps@treasury.gov. Applications must be submitted by June 2 , 2011. Guidance and 

a template for an applicant's lending plan can be found at www.treasury.gov/SBLF. 

CDLF Eligibility Requirements

To be eligible for participation in SBLF, your CDLF must:

• be certified by the Community Development Financial Institutions Fund (CDFI Fund) as a CDFI or have applied for 

such certification prior to May 2 , 2011 and receive such certification by August 1; 

• be exempt from taxation under the Internal Revenue Code of 1986; 

• have at least three years of operating experience;

• have audited financial statements for the three most recent fiscal years ended and a clean audit opinion with 

respect to its audited financial statements for the most recent fiscal year-end;

• have total assets of $10 billion or less, as reported in audited financial statements for the fiscal year that ended in 

calendar year 2009; and,

• satisfy the following financial requirements:

− average net income for the three most recent fiscal years is positive; 

− cash and cash equivalents are equal to or greater than operating expenses for each of the four most recent 

quarters ended; 

− year-end cash and cash equivalents are equal to or greater than 25% of annual operating expenses for one or 

both of the two most recent fiscal years ended; 

− net assets plus the amount of liabilities (if any) relating to equity equivalent instruments that are reflected on 

the CDFI’s balance sheet to total assets is at least 20%, without including Treasury’s investment; 

− loan loss reserves to loans and leases 90 days or more delinquent (including loans sold with full recourse) is at 

least 30%; 

− loans and leases 90 days or more delinquent (including loans sold with full recourse) to total equity (defined as 

unrestricted net assets plus loss reserves, to the extent that such loan loss reserves are not otherwise included 

in unrestricted net assets) is less than 40%; and,

− outstanding loans eligible for inclusion in Qualified CDLF Small Business Lending, as defined in the “Initial Call 

Report for Community Development Loan Funds” (included herein), are at least 10% of total loans 

outstanding.

For more information on CDLF eligibility criteria, please visit the SBLF website at www.treasury.gov/SBLF and review the 

Summary of Terms for Equity Equivalent Capital for CDLFs. 

To get started on your application, refer to the “Application Checklist for Community Development Loan Funds Applying for 

SBLF Funding” included herein. Please note: Treasury may conduct an on-site inspection and discuss matters relevant to 

the application with the applicant’s principal officers as part of the application review process.

For Additional Information

If you have general questions about the application process, please call the SBLF information line at 888-832-1147 

(Monday-Friday, 9:00 AM-7:00 PM ET). For communications pertaining to a specific institution, please email 

CDLFInstitutions@treasury.gov, a Treasury email address.
 

 

Treasury Department Form: TD F 102.5 (05/ϯϭ/11) 2 OMB Number 1505-0232

Application Checklist

For Community Development Loan Funds

This checklist should be used to ensure that your application includes all of the required application documents. 

 A completed, signed, and dated application package, which includes the attached Application, SBLF Initial Call 

Report for Community Development Loan Funds, Eligibility Worksheet, and Loan Portfolio Quality Worksheet. 

(For CDLFs using digital signatures, the completed electronic application is submitted as a single document. For 

CDLFs using handwritten signatures, both the completed electronic application and a scanned copy of the entire 

application package, including signature page, must be submitted.)

 Audited annual financial statements for each of the three most recent fiscal years ended as of the date of 

application. (If the audit for the most recent fiscal year-end is not complete at the time of application, it must be 

completed and submitted to Treasury by August 1. In this case, please submit a draft of such statements at the 

time of application.) 

 An audit opinion letter for the annual financial statements of the most recent fiscal year ended as of the date of 

application. (If the audit opinion letter for the most recent fiscal year-end is not complete at the time of 

application, it must be completed and submitted to Treasury by August 1. In this case, please submit the prior 

year’s audit opinion letter at the time of application.) 

 Quarterly financial statements for each of the four most recent quarters ended prior to the date of application. 

 An IRS determination letter with respect to your CDLF’s tax-exempt status.

 A completed Certification of Material Events Form as designated by the CDFI Fund. 

 A small business lending plan (guidance and a template for your CDLF’s small business lending plan can be found at 

www.treasury.gov/SBLF). 

GAAP Financial Statements Required: All financial statements must be prepared in accordance with generally accepted 

accounting principles (GAAP) in the United States. 
 

 

Treasury Department Form: TD F 102.5 (05/ϯϭ/11) 3 OMB Number 1505-0232

Application

For Community Development Loan Funds 

Name of CDLF: __________________________________________________________ 

Employer Identification Number (EIN): ―

(e.g., 89-1234567)

CDFI Certification Number: 

 (e.g., 941CE123456)

If your CDLF has submitted a CDFI Certification Application to the CDFI Fund, but has not yet received a CDFI Certification 

Number, please note the date on which the application was submitted: _____________ 

Only organizations currently certified as CDFIs, or that have a pending CDFI certification application that was submitted to the CDFI Fund prior to May 25, 

2011, are eligible to apply for SBLF funding.

Address: _______________________________________________________________ 

City: ________________________ State: ______ ͅ ͅ ͅ ͅ ͅ ͅ ͅ ͅ ͅ ͅ ͅ ͅ ͅ ͅ ͅ ͅ Zip Code: ____________

Primary Contact Name: ___________________________________________________ 

Primary Contact Telephone: ______________________ Primary Contact Email: ____________________________ 

Asset Size: $__________________________ (round down to nearest thousand – for example “$250,000” vs. “$250,125”) 

Asset size is the amount of total assets reported in the applicant’s audited annual financial statements for the fiscal year ended in calendar year 2009.

Requested Investment Amount: $___________________________________________ 

The permissible amount depends in part on the applicant’s asset size. The maximum investment is 5% of the asset size above. 

CDLF Applicant Attestation

I, the undersigned Chief Executive Officer (or equivalent authorized official) of the named Community Development Loan 

Fund, attest that this application and all documents submitted along with this application, for this application date, have

been prepared in conformance with the instructions issued by the Treasury and are true and correct to the best of my 

knowledge and belief.

I also attest that the named Community Development Loan Fund is in compliance with all of the terms and conditions of its 

debt obligations. If it is not in compliance, I have provided a written explanation of the reason for noncompliance with this 

application on the “Additional Information” page. 

Signature of Authorized Official: ____________________________________________ 

Name of Authorized Official: _______________________________________________ 

Title of Authorized Official: ________________________________________________ 

Date: ____________________________________ 
 

 

Treasury Department Form: TD F 102.5 (05/ϯϭ/11) 4 OMB Number 1505-0232

SBLF Initial Call Report

For Community Development Loan Funds

Definition of Qualified CDLF Small Business Lending

For a loan made by a CDLF to be eligible for inclusion in Qualified CDLF Small Business Lending, it must meet the following criteria:

• The original principal and commitment amount of the loan must be $10 million or less.

• The loan must not be to a business with more than $50 million in revenues.

• The loan must fall within one of the following four categories:

− Commercial and industrial loans: Loans made for commercial and industrial purposes to sole proprietorships, 

partnerships, corporations (including non-profit corporations), and other business enterprises, whether secured (other 

than those that meet the definition of a “loan secured by real estate”) or unsecured, single-payment or installment. 

This category includes microenterprise loans and lines of credit.

− Owner-occupied nonfarm, nonresidential real estate loans: Loans secured by nonfarm, nonresidential commercial real 

estate property, including community facilities. The primary source of repayment must be the cash flow from the 

borrower/owner or enterprise's operations and activities (or an affiliate subsidiary or related Special Purpose Entity). 

− Loans to finance agricultural production and other loans to farmers: Loans made for the purpose of financing 

agricultural production. Include such loans whether secured (other than those that meet the definition of a “loan 

secured by real estate“) or unsecured and whether made to farm and ranch owners and operators. 

− Loans secured by farmland: Loans made for farmland and improvements and secured by mortgages or other real 

estate liens. Farmland includes all land known to be used or usable for agricultural purposes, such as crop and livestock 

production, grazing or pasture land, whether tillable or not and whether wooded or not.

Qualified CDLF Small Business Lending is defined, without consideration of tax status, to include borrowers that are sole 

proprietorships, partnerships, corporations, tax-exempt organizations, and cooperatives.

Date of Call Report: ____________________

Dates of Most Recent Quarter Ended (mm/dd/yy – mm/dd/yy): _________________ – _________________

CDLF Call Report Table for Most Recent Quarter End All Loans Outstanding Qualified CDLF Small Business 

Lending

1. Commercial and industrial loans 1 $ 

2. Owner-occupied nonfarm, nonresidential real estate loans 2 $ 

3. Loans to finance agricultural production and other loans to farmers 3 $ 

4. Loans secured by farmland 4 $ 

5. All other outstanding loans (loans not included in lines 1-4) 5 $ 

6. Total (sum of lines 1-5) 6 $ 
 

 

Treasury Department Form: TD F 102.5 (05/ϯϭ/11) 5 OMB Number 1505-0232

Eligibility Worksheet

For Community Development Loan Funds

Instructions

Please complete the following tables in full prior to submitting your institution’s application. For items referencing year-end 

financial statements, ensure that these figures reflect those reported in your CDLF’s audited financial statements as submitted. To 

be eligible for SBLF funding, your institution must meet the criteria specified. Your CDLF will also need to meet these criteria for the 

periods ended in relation to the date of the financing. 

Optional: For items (D) through (F), if your CDLF does not meet the criteria as of the most recent fiscal year-end, but does meet all 

criteria as of the most recent quarter-end, then Treasury will consider your institution’s eligibility for SBLF funding based on the 

quarter-end results, provided that you submit by August 1 a review completed by an external auditor of such quarterly financial 

statements and this review does not identify any material modifications required for the financial statements to be in accordance 

with GAAP.

If your CDLF intends to submit such a review of its financial statements for the most recent quarter-end, please check this box:  

Beginning (mm/dd/yy) Ending (mm/dd/yy)

1. Dates of the most recent fiscal year-end (FYE) as of the date of your 

application 1 

2. Dates of the most recent quarter-end (QE) as of the date of your 

application 2 

A. Average net income for the three most recent fiscal years is positive. 

3. Net income for the most recent FYE 3 $ 

4. Net income for the 2nd most recent FYE 4 $ 

5. Net income for the 3rd most recent FYE 5 $ 

6. Sum of last three years of net income (sum of lines 3-5) 6 $ 

7. Average net income (line 6 divided by ‘3’) 7 $ 

B. Operating liquidity ratios for the four most recent quarters ended are 

1.0 or greater.

4

th Most 

Recent QE 

3

rd Most 

Recent QE 

2

nd Most 

Recent QE 

Most

Recent QE 

8. Cash and cash equivalents 8 $ 

9. Operating expenses 9 $ 

10. Operating liquidity ratios for each QE (line 8 divided by line 9, rounded

to the nearest tenth) 10 x 

C. Operating liquidity ratios for one or both of the two most recent fiscal 

years ended are 1.0 or greater. 2

nd Most Recent FYE Most Recent FYE 

11. Cash and cash equivalents 11 $ 

12. Annual operating expenses 12 $ 

13. 25% of annual operating expenses (line 12 multiplied by 25%) 13 $ 

14. Operating liquidity ratios for two most recent FYE (line 11 divided by line 

13, rounded to the nearest tenth) 14 x 
 

 

Treasury Department Form: TD F 102.5 (05/ϯϭ/11) 6 OMB Number 1505-0232

D. Net assets plus the amount of liabilities (if any) relating to equity 

equivalents (EQ2) to total assets (excluding assets for which the CDLF 

bears no economic risk) is at least 20%. 

Most Recent QE Most Recent FYE 

15. Total assets 15 $ 

16. Assets for which the CDLF bears no economic risk 

(e.g., loans managed for other creditors or capitalized with non-recourse 

debt provided by a third-party) 16 $ 

17. Total assets excluding assets for which the CDLF bears no economic risk 

(line 15 minus line 16) 17 $ 

18. Total net assets 18 $ 

19. Total liabilities (if any) relating to EQ2s 19 $ 

20. Total net assets plus EQ2s (line 18 plus line 19) 20 $ 

21. Net assets plus EQ2s as a percentage of total assets, excluding assets 

for which the CDLF bears no economic risk (line 20 divided by line 17, 

multiplied by ‘100’) 21 % 

E. Ratio of loan loss reserves to loans and leases 90 days or more 

delinquent (including loans sold with full recourse) is at least 30%. Most Recent QE Most Recent FYE 

22. Loan loss reserves 22 $ 

23. Loans and leases 90 days or more delinquent, including loans sold with 

full recourse 23 $ 

24. Reserves as a percentage of delinquency (line 22 divided by line 23, 

multiplied by ‘100’) 24 % 

F. Ratio of loans and leases 90 days or more delinquent (including loans 

sold with full recourse) to unrestricted net assets plus loan loss 

reserves is less than 40%.

Most Recent QE Most Recent FYE 

25. Loans and leases 90 days or more delinquent, including loans sold with 

full recourse (line 23) 25 $ 

26. Unrestricted net assets 26 $ 

27. Loan loss reserves not included in unrestricted net assets 27 $ 

28. Unrestricted net assets plus loan loss reserves (line 26 plus line 27) 28 $ 

29. Delinquency as a percentage of unrestricted net assets plus loan loss 

reserves (line 25 divided by line 28, multiplied by ‘100’) 29 % 

G. Outstanding loans eligible for inclusion in Qualified CDLF Small 

Business Lending* are equal to or greater than 10% of total loans 

outstanding.

Most Recent QE

30. Total Qualified CDLF Small Business Lending (column 2, line 6 of the 

SBLF Initial Call Report for Community Development Loan Funds) 30 $ 

31. Total of all loans outstanding (column 1, line 6 of the SBLF Initial Call 

Report for Community Development Loan Funds) 31 $ 

32. Qualified CDLF Small Business Lending as a percentage of total loans 

outstanding (line 30 divided by line 31, multiplied by ‘100’) 32 % 

*These loans must meet the criteria for Qualified CDLF Small Business Lending, as defined in the “Initial Call Report for Community Development 

Loan Funds.”
 

 

Treasury Department Form: TD F 102.5 (05/ϯϭ/11) 7 OMB Number 1505-0232

Loan Portfolio Quality Worksheet

For Community Development Loan Funds

Aggregate Loan Portfolio

3rd Most Recent 

FYE 

2nd Most Recent 

FYE 

Most Recent 

FYE 

# $ # $ # $ 

1. Portfolio outstanding 1 

2. Loans delinquent (include any loan or lease that is 90 or more days 

past due as of the reporting year-end) 2 

3. Loans restructured (include any loan or lease that was restructured in 

the prior twelve months as of the reporting year-end) 3 

4. Loans delinquent prior to restructuring (include any loan or lease that 

was restructured in the prior twelve months as of the reporting year-end

that was 90 days or more past due at the date of restructuring) 4 

5. Total portfolio-at-risk (line 2 divided by line 1) 5 

Loan Loss Reserves and Write-Offs 3

rd Most Recent 

FYE 

2

nd Most Recent 

FYE 

Most Recent 

FYE 

6. Total outstanding loan portfolio 6 $ 

7. Net write-offs or net charge-offs 7 $ 

8. Annual net loan loss ratio (line 7 divided by line 6) 8 % 

9. Loan loss reserves (cash) 9 $ 

10. Loan loss reserves (accrual) 10 $ 

11. Loan loss reserve ratio (sum of lines 9 and 10, divided by line 6) 11 % 

Five Largest Loans Delinquency 

Status*

Principal Amount

($ amount)

Percentage of 

Loan Portfolio

Origination Date

(mm/dd/yy)

Maturity Date

(mm/dd/yy) Loan Type**

12. Largest loan

13. 2nd largest loan

14. 3rd largest loan

15. 4th largest loan

16. 5th largest loan

* Delinquency Status: Use these categories: current (less than 30 days), 30-59 days, 60-89 days, or 90+ days. 

** Loan Type: Examples of loan type include: business, microenterprise, commercial real estate, multi-family housing, education facility, 

health facility, etc. 

For loans secured by real estate, 

please complete:

Most Recent 

Appraisal Value

Most Recent 

Appraisal Date

Largest loan (line 12)

2

nd largest loan (line 13)

3rd largest loan (line 14)

4

th largest loan (line 15)

5

th largest loan (line 16)
 

 

Treasury Department Form: TD F 102.5 (05/ϯϭ/11) 8 OMB Number 1505-0232

Additional Information

Please include any additional information regarding your CDLF’s application that may be relevant to Treasury, including any notes 

with respect to the reporting of required data or calculation of the financial eligibility requirements.