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Thank you for choosing Middlesex Savings Bank for your Paycheck Protection Program (PPP) Loan. Please complete this document and submit it along with your completed application, PPP calculator, and supporting documentation using the Secure Portal provided on our website. Note: This document will only work in Adobe Acrobat or Acrobat Reader. Download Acrobat Reader Here Borrower's Legal Business Name: ____________________________________ Borrower's DBA: ______________________________________________ Borrower's TIN: ______________________________________________ Borrower's bank account number for funds to be deposited into: ___________________ The name of your loan officer or branch manager (if no loan officer): _________________ Number of employees: ___________ Was your business in operation as of February 15, 2020? Yes N o Are you a small business or Sole Proprietorship? Are you an Independent Contractor or Self Employed? What is your NAICS Code (Look up your NAICS code here)? _______________ Yes Yes No No

Yes No Yes No - Middlesex Savings Bank...Yes Yes No No. Middlesex Savings Bank right there with you . Title: MSB Borrower Paycheck Protection Program Checklist Created Date: 3/31/2020

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Page 1: Yes No Yes No - Middlesex Savings Bank...Yes Yes No No. Middlesex Savings Bank right there with you . Title: MSB Borrower Paycheck Protection Program Checklist Created Date: 3/31/2020

Thank you for choosing Middlesex Savings Bank for your Paycheck Protection Program (PPP) Loan. Please complete this document and submit it along with your completed application, PPP calculator, and supporting documentation using the Secure Portal provided on our website.

Note: This document will only work in Adobe Acrobat or Acrobat Reader. Download Acrobat Reader Here

Borrower's Legal Business Name: ____________________________________

Borrower's DBA: ______________________________________________

Borrower's TIN: ______________________________________________

Borrower's bank account number for funds to be deposited into: ___________________

The name of your loan officer or branch manager (if no loan officer): _________________

Number of employees: ___________

Was your business in operation as of February 15, 2020? Yes No

Are you a small business or Sole Proprietorship?

Are you an Independent Contractor or Self Employed?

What is your NAICS Code (Look up your NAICS code here)? _______________

Yes

Yes No

No

https://www.naics.com/search/
https://get.adobe.com/reader/

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