3-Attachment-SOW-Form468.pdf

PDF 4 MB Posted Jul 18, 2018

Attached to: Independent Valuation Consulting Services - SBA - OII (Office of Investment and Innovation)
Solicitation number: 73351018R0004
Issued by: Small Business Administration Office of Performance Management and the Chief Financial Officer

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3 - SOW Attachment - Form 468

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8-PricingSchedule-73351018R0004-Edit1.docx	DOCX document	Jul 30, 2018
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2-Valuation-OII-SOW_OGC_FINAL_6-27-18.doc	DOC document	Jul 18, 2018
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ANNUAL FINANCIAL REPORT

ON SBA FORM 468

(Partnership SBICs)

OMB Approval No. 3245-0063

Name of Licensee: Test 4

License Number: 12/34-5688

Street Address:

City, State, and Zip Code: , , County:

Employer ID Number: 44-4444444

12/31/2015For the Reporting Period Ending:

A - Fund Focus:

B - Ownership: Bank Associated Partnership

12Months:

Expiration Date 10/31/2017

Please Note: The estimated burden for completing this form is 35 hours per response if a wind-up plan is required and 25 hours per response if a wind-up plan is not required. You will not be required to respond to this information collection if a valid OMB approval number is not displayed. If you have questions or comments concerning this estimate or other aspects of this information collection, please contact the U.S. Small Business Administration, Chief Administrative Information Branch, Washington, D.C. 20416 and/or SBA Desk Officer, Office of Management and Budget, New Executive Office Building, Room 10202, Washington, D.C. 20503. PLEASE DO NOT SEND FORMS TO OMB.

SBA Form 468.2 (03/14) Previous edition obsolete. Page 1P

ANNUAL FINANCIAL REPORT

ON SBA FORM 468

(Partnership SBICs)

License Number: 12/34-5688

Street Address:

City, State, and Zip Code: , , County:

Employer ID Number: 44-4444444

12/31/2015For the Reporting Period Ending:

A - Fund Focus:

B - Ownership: Bank Associated Partnership

12Months:

Expiration Date 10/31/2017

SBA Form 468.2 (03/14) Previous edition obsolete. Page 1P

STATEMENT OF FINANCIAL POSITION

AS OF 12/31/2015

(Amounts rounded to the nearest dollar)

Name of the Licensee: Test 4

Expiration Date 10/31/2017

ASSETS:

LOANS AND INVESTMENTS

Cost:

(Col. 1)

Unrealized Depreciation

(Col. 2)

Unrealized Appreciation

(Col. 3)

Reported Value (1) (Col. 4)

1 Loans $0 $0 $0 $0

Portfolio Securities:

4 Total Portfolio Securities $0 $0 $0 $0

2 Debt Securities $0 $0 $0 $0

3 Equity Securities $0 $0 $0 $0

Assets Acquired in Liquidation of Portfolio Securities:

5 Receivables from Sale of Assets Acquired $0 $0 $0 $0

6 Assets Acquired $0 $0 $0 $0

7 Total Assets Acquired $0 $0 $0 $0

8 Operating Concerns Acquired $0 $0 $0 $0

9 Notes and Other Securities Received $0 $0 $0 $0

10 TOTAL LOANS AND INVESTMENTS $0 $0 $0 $0

11 Less Current Maturities $0

12 Loans and Investments Net of Current Maturities $0

Investment in 301(d) Licensee (2)

13 Name/License No. $0

CURRENT ASSETS

14 Cash and Cash Equivalents $0

23 Current Maturities of Other Securities $0

22 Current Maturities of Operating Concerns Acquired $0

21 Current Maturities of Assets Acquired $0

20 Current Maturities of Portfolio Securities $0

19 Less: Allowance for Losses (lines 16, 17, and 18) $0

18 Receivables from Parent or Other Associates $0

17 Notes and Accounts Receivable $0

16 Interest and Dividends Receivable $0

15 Invested Idle Funds $0

24 Other (specify)

25 Other (specify)

$0 $0

OTHER ASSET

26 Net Furniture and Equipment $0

27 Net Leverage Fees $0

28 Other (specify) $0

30 TOTAL ASSETS $0

(1) Column Headings apply to items 1 through 12 only. (Cost - Unrealized Depreciation + Unrealized Appreciation = Value)

(2) Note to item 13 should include percent owned, cost basis and changes resulting from equity method of accounting.

SBA Form 468.2 (03/14) Previous edition obsolete. Page 2P

29 Other (specify) $0 $0

License No: 12/34-5688

STATEMENT OF FINANCIAL POSITION

AS OF 12/31/2015

ASSETS:

LOANS AND INVESTMENTS

Cost:

(Col. 1)

Unrealized Depreciation

(Col. 2)

Unrealized Appreciation

(Col. 3)

Reported Value (1) (Col. 4)

1 Loans $0 $0 $0 $0

Portfolio Securities:

4 Total Portfolio Securities $0 $0 $0 $0

2 Debt Securities $0 $0 $0 $0

3 Equity Securities $0 $0 $0 $0

Assets Acquired in Liquidation of Portfolio Securities:

5 Receivables from Sale of Assets Acquired $0 $0 $0 $0

6 Assets Acquired $0 $0 $0 $0

7 Total Assets Acquired $0 $0 $0 $0

8 Operating Concerns Acquired $0 $0 $0 $0

9 Notes and Other Securities Received $0 $0 $0 $0

10 TOTAL LOANS AND INVESTMENTS $0 $0 $0 $0

11 Less Current Maturities $0

12 Loans and Investments Net of Current Maturities $0

Investment in 301(d) Licensee (2)

13 Name/License No. $0

CURRENT ASSETS

14 Cash and Cash Equivalents $0

23 Current Maturities of Other Securities $0

22 Current Maturities of Operating Concerns Acquired $0

21 Current Maturities of Assets Acquired $0

20 Current Maturities of Portfolio Securities $0

19 Less: Allowance for Losses (lines 16, 17, and 18) $0

18 Receivables from Parent or Other Associates $0

17 Notes and Accounts Receivable $0

16 Interest and Dividends Receivable $0

15 Invested Idle Funds $0

24 Other (specify)

25 Other (specify)

$0 $0

OTHER ASSET

26 Net Furniture and Equipment $0

27 Net Leverage Fees $0

28 Other (specify) $0

30 TOTAL ASSETS $0

(1) Column Headings apply to items 1 through 12 only. (Cost - Unrealized Depreciation + Unrealized Appreciation = Value)

(2) Note to item 13 should include percent owned, cost basis and changes resulting from equity method of accounting.

SBA Form 468.2 (03/14) Previous edition obsolete. Page 2P

29 Other (specify) $0 $0

License No: 12/34-5688

STATEMENT OF FINANCIAL POSITION

Name of the Licensee: Test 4 License No: 12/34-5688

Liabilities

LIABILITIES AND CAPITAL

31 Notes and Debentures payable to or guaranteed by SBA. $0

Long-Term Debt

c. SBA Profit Participation Allocated for Distribution $0 $0 $0

32 Notes and Debentures Payable to Others $0

33a. Participating Securities Held or Guaranteed by SBA $0

b. Earned Prioritized Payments Allocated for Distribution $0

Current Liabilities 34 Accounts Payable $0

35 Due to Parent or Other Associates

a. Management Expenses Due to Associates $0

b. Other Due to Associates $0 $0

36. Accrued Interest Payable $0

PARTNERS' CAPITAL

46 Private Partners' Contributed Capital

51 Undistributed Realized Earnings (line 49 plus line 50) $0

50 Undistributed Net Realized Earnings $0

49 Non-Cash Gains/Income $0

48 Unrealized Gains (Loss) on Securities Held $0

b. Limited Partner(s) $0 $0

a. General Partner(s) $0

47 Other (specify) $0

53 TOTAL LIABILITIES AND PARTNERS' CAPITAL $0

SBA Form 468.2 (03/14) Previous edition obsolete. Page 3P

37. Accrued Taxes Payable $0

38. Distributions Payable $0

40 Other (specify) $0

41 Other (specify) $0 $0

39. Short-term notes Payable/Lines of Credit $0

Other Liabilities 42 Deferred Credits $0

43 Deferred Fee Income $0

44 Other (specify) $0

45 Total Liabilities $0

52 TOTAL PARTNERS' CAPITAL $0

STATEMENT OF FINANCIAL POSITION

AS OF 12/31/2015

Liabilities

LIABILITIES AND CAPITAL

31 Notes and Debentures payable to or guaranteed by SBA. $0

Long-Term Debt

c. SBA Profit Participation Allocated for Distribution $0 $0 $0

32 Notes and Debentures Payable to Others $0

33a. Participating Securities Held or Guaranteed by SBA $0

b. Earned Prioritized Payments Allocated for Distribution $0

Current Liabilities 34 Accounts Payable $0

35 Due to Parent or Other Associates

a. Management Expenses Due to Associates $0

b. Other Due to Associates $0 $0

36. Accrued Interest Payable $0

PARTNERS' CAPITAL

46 Private Partners' Contributed Capital

51 Undistributed Realized Earnings (line 49 plus line 50) $0

50 Undistributed Net Realized Earnings $0

49 Non-Cash Gains/Income $0

48 Unrealized Gains (Loss) on Securities Held $0

b. Limited Partner(s) $0 $0

a. General Partner(s) $0

47 Other (specify) $0

53 TOTAL LIABILITIES AND PARTNERS' CAPITAL $0

SBA Form 468.2 (03/14) Previous edition obsolete. Page 3P

37. Accrued Taxes Payable $0

38. Distributions Payable $0

40 Other (specify) $0

41 Other (specify) $0 $0

39. Short-term notes Payable/Lines of Credit $0

Other Liabilities 42 Deferred Credits $0

43 Deferred Fee Income $0

44 Other (specify) $0

45 Total Liabilities $0

52 TOTAL PARTNERS' CAPITAL $0

STATEMENT OF OPERATIONS REALIZED

For 12 MONTHS ENDED 12/31/2015

INVESTMENT INCOME

1 Interest Income $0

2 Dividend Income $0

10 GROSS INVESTMENT INCOME $0

6 Application, Closing and Other Fees $0

7 Interest on Cash Equivalents and Invested Idle Funds $0

5 Fees for Management Services $0

4 Income (Loss) from Investments in Section 301(d) Licensee $0

3 Income (Loss) from Investments in Partnerships/Flow-through Entities $0

Loans and Investment (net of $0 Expenses)

8 Income from Assets Acquired in Liquidation of

9 Other Income $0

EXPENSES

11 Interest Expense

a. Interest Expense -- Earned Prioritized Payments, Charges & Adjustments $0

b. Interest Expense -- SBA Debentures $0

$0c. Other Interest Expense $0

$012 Commitment Fees & Other Financial Costs

$013 Compensation and Benefits (Officer and Employee)

$014 Investment Advisory and Management Services

$015 Partners' Meetings

$016 Appraisal and Investigation

$017 Advertising, Communication and Travel

$018 Cost of Space Occupied

a. Amortization of Leverage Fees $0

$0b. Other Depreciation and Amortization $0

19 Depreciation and Amortization

$020 Insurance

$021 Payroll and Other Taxes

$022 Provision for Losses on Receivables (excluding loans receivable)

$023 Legal Fees

$024 Audit and Examination Fees

25 Miscellaneous Expenses

a. Misc. #1 $0

b. Misc. #2 $0

c. Misc. #3 $0

d. Misc. #4 $0

e. Misc. #5 $0

f. Misc. #6 $0 $0

28 NET REALIZED GAIN (LOSS) ON INVESTMENTS (1) $0

29 NET INCOME (LOSS) BEFORE NONRECURRING ITEMS $0

30 Extraordinary Item $0

31 Cumulative Effect of Change in Accounting Principle

32 NET INCOME (LOSS)

(1) Provide supporting detail for all realized gains and losses on Page 13P of this form.

SBA Form 468.2 (03/14) Previous edition obsolete.

Page 4P

26 TOTAL EXPENSES

27 NET INVESTMENT INCOME (LOSS)

STATEMENT OF OPERATIONS REALIZED

For 12 MONTHS ENDED 12/31/2015

INVESTMENT INCOME

1 Interest Income $0

2 Dividend Income $0

10 GROSS INVESTMENT INCOME $0

6 Application, Closing and Other Fees $0

7 Interest on Cash Equivalents and Invested Idle Funds $0

5 Fees for Management Services $0

4 Income (Loss) from Investments in Section 301(d) Licensee $0

3 Income (Loss) from Investments in Partnerships/Flow-through Entities $0

Loans and Investment (net of $0 Expenses)

8 Income from Assets Acquired in Liquidation of

9 Other Income $0

EXPENSES

11 Interest Expense

a. Interest Expense -- Earned Prioritized Payments, Charges & Adjustments $0

b. Interest Expense -- SBA Debentures $0

$0c. Other Interest Expense $0

$012 Commitment Fees & Other Financial Costs

$013 Compensation and Benefits (Officer and Employee)

$014 Investment Advisory and Management Services

$015 Partners' Meetings

$016 Appraisal and Investigation

$017 Advertising, Communication and Travel

$018 Cost of Space Occupied

a. Amortization of Leverage Fees $0

$0b. Other Depreciation and Amortization $0

19 Depreciation and Amortization

$020 Insurance

$021 Payroll and Other Taxes

$022 Provision for Losses on Receivables (excluding loans receivable)

$023 Legal Fees

$024 Audit and Examination Fees

25 Miscellaneous Expenses

a. Misc. #1 $0

b. Misc. #2 $0

c. Misc. #3 $0

d. Misc. #4 $0

e. Misc. #5 $0

f. Misc. #6 $0 $0

28 NET REALIZED GAIN (LOSS) ON INVESTMENTS (1) $0

29 NET INCOME (LOSS) BEFORE NONRECURRING ITEMS $0

30 Extraordinary Item $0

31 Cumulative Effect of Change in Accounting Principle

32 NET INCOME (LOSS)

(1) Provide supporting detail for all realized gains and losses on Page 13P of this form.

SBA Form 468.2 (03/14) Previous edition obsolete.

Page 4P

26 TOTAL EXPENSES

27 NET INVESTMENT INCOME (LOSS)

STATEMENT OF CASH FLOWS

(page 1 of 2)

OPERATING ACTIVITIES

1 Interest Received from Portfolio Concerns $0

2 Dividend Received from Portfolio Concerns $0

6 Cash Received from Assets Acquired in Liquidation $0

7 Other Operating Cash Receipts $0

5 Interest on Cash Equivalents and Invested Idle Funds $0

4 Management Services and Other Fees Received $0

3 Other Income Received from Portfolio Concerns $0

Cash Inflows

8 Interest Paid (excl. Earned Prioritized Payments, Charges and Adjustments)

9 Commitment Fees and Other Financial Costs

13 Other Operating Cash Disbursements

14 NET CASH PROVIDED BY (USED IN) OPERATING ACTIVITIES $0

12 Operating Expenditures (Excluding Compensation and Benefits)

11 Partners' and Employees' Compensation and Benefits

10 Investment Advisory and Management Fees

Cash Outflows

INVESTING ACTIVITIES

15 Loan Principal Payments Received from Portfolio Concerns $0

16 Returns of Capital Received from Portfolio Concerns $0

19 Other (Specify) $0

18 Liquidation of Idle Funds Investments $0

17 Net Proceeds from Disposition of Portfolio Securities $0

Cash Inflows

20 Purchase of Portfolio Securities $0

21 Loans to Portfolio concerns $0

22 Idle Funds Investment $0

Cash Outflows

23 Other (Specify) $0

24 NET CASH PROVIDED BY (USED IN) INVESTING ACTIVITIES $0

FINANCING ACTIVITIES

25 Proceeds from Issuance of SBA-Guaranteed Debentures $0

26 Proceeds from Issuance of SBA-Guaranteed Participating Securities $0

29 Other (Specify) $0

28 Proceeds from Sale of Stock or Other Capital Contribution $0

27 Proceeds from Non-SBA Borrowing $0

Cash Inflows

30 SBA Leverage Fees $0

31 Principal Payments on SBA-Guaranteed Debentures $0

35 Prioritized Payments, Charges and Adjustments Paid $0

39 NET CASH PROVIDED BY (USED IN) FINANCING ACTIVITIES $0

34 Redemption of Private Partnership Interests $0

33 Redemption of Participating Securities $0

32 Principal Payments on Non-SBA Borrowing $0

Cash Outflows

36 SBA Profit Participation Paid

37 Other Distributions Paid

38 Other (Specify) $0

SBA Form 468.2 (03/14) Previous edition obsolete. Page 5P

STATEMENT OF CASH FLOWS

For 12 MONTHS ENDED 12/31/2015

(page 1 of 2)

OPERATING ACTIVITIES

1 Interest Received from Portfolio Concerns $0

2 Dividend Received from Portfolio Concerns $0

6 Cash Received from Assets Acquired in Liquidation $0

7 Other Operating Cash Receipts $0

5 Interest on Cash Equivalents and Invested Idle Funds $0

4 Management Services and Other Fees Received $0

3 Other Income Received from Portfolio Concerns $0

Cash Inflows

8 Interest Paid (excl. Earned Prioritized Payments, Charges and Adjustments)

9 Commitment Fees and Other Financial Costs

13 Other Operating Cash Disbursements

14 NET CASH PROVIDED BY (USED IN) OPERATING ACTIVITIES $0

12 Operating Expenditures (Excluding Compensation and Benefits)

11 Partners' and Employees' Compensation and Benefits

10 Investment Advisory and Management Fees

Cash Outflows

INVESTING ACTIVITIES

15 Loan Principal Payments Received from Portfolio Concerns $0

16 Returns of Capital Received from Portfolio Concerns $0

19 Other (Specify) $0

18 Liquidation of Idle Funds Investments $0

17 Net Proceeds from Disposition of Portfolio Securities $0

Cash Inflows

20 Purchase of Portfolio Securities $0

21 Loans to Portfolio concerns $0

22 Idle Funds Investment $0

Cash Outflows

23 Other (Specify) $0

24 NET CASH PROVIDED BY (USED IN) INVESTING ACTIVITIES $0

FINANCING ACTIVITIES

25 Proceeds from Issuance of SBA-Guaranteed Debentures $0

26 Proceeds from Issuance of SBA-Guaranteed Participating Securities $0

29 Other (Specify) $0

28 Proceeds from Sale of Stock or Other Capital Contribution $0

27 Proceeds from Non-SBA Borrowing $0

Cash Inflows

30 SBA Leverage Fees $0

31 Principal Payments on SBA-Guaranteed Debentures $0

35 Prioritized Payments, Charges and Adjustments Paid $0

39 NET CASH PROVIDED BY (USED IN) FINANCING ACTIVITIES $0

34 Redemption of Private Partnership Interests $0

33 Redemption of Participating Securities $0

32 Principal Payments on Non-SBA Borrowing $0

Cash Outflows

36 SBA Profit Participation Paid

37 Other Distributions Paid

38 Other (Specify) $0

SBA Form 468.2 (03/14) Previous edition obsolete. Page 5P

STATEMENT OF CASH FLOWS

(page 2 of 2)

41 INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS

42 CASH AND CASH EQUIVALENTS AT BEGINNING OF PERIOD

43 CASH AND CASH EQUIVALENTS AT END OF PERIOD (line 14, page 2P)

RECONCILIATION OF NET INCOME (LOSS) TO NET CASH PROVIDED BY (USED IN) OPERATING ACTIVITIES

44 Net Income (Loss) (Line 32, page 4P) $0

Adjustments to Reconcile Net Income (Loss) to Net Cash Provided by (used in) Operating Activities:

46 Provision for Losses on Accounts Receivable (line 22, page 4P)

45 Depreciation and Amortization (line 19, page 4P)

47 Earned Prioritized Payments, Charges, and Adjustments

48 Realized (Gains) Losses on Investments (line 28, page 4P)

49 Other (Specify)

$0 b.

Changes in Operating Assets and Liabilities Net of Noncash Items

51 (Increase) Decrease in Other Current Assets

50 (Increase) Decrease in Interest and Dividends Receivable

52 Increase (Decrease) in Accounts Payable

53 Increase (Decrease) in Accrued Interest Payable

54 Increase (Decrease) in Accrued Taxes Payable

55 Increase (Decrease) in Dividends Payable

56 Increase (Decrease) in Other Current Liabilities $0

57 Other (Specify) $0

58 Other (Specify) $0

59 NET CASH PROVIDED BY (USED IN) OPERATING ACTIVITIES $0

(Total must agree with line 14, page 5P)

Supplemental disclosure of non-cash financing and investing activities may be required.

See ASC 230, "Statement of Cash Flows".

SBA Form 468.2 (03/14) Previous edition obsolete. Page 6P

STATEMENT OF CASH FLOWS

For 12 MONTHS ENDED 12/31/2015

(page 2 of 2)

41 INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS

42 CASH AND CASH EQUIVALENTS AT BEGINNING OF PERIOD

43 CASH AND CASH EQUIVALENTS AT END OF PERIOD (line 14, page 2P)

RECONCILIATION OF NET INCOME (LOSS) TO NET CASH PROVIDED BY (USED IN) OPERATING ACTIVITIES

44 Net Income (Loss) (Line 32, page 4P) $0

Adjustments to Reconcile Net Income (Loss) to Net Cash Provided by (used in) Operating Activities:

46 Provision for Losses on Accounts Receivable (line 22, page 4P)

45 Depreciation and Amortization (line 19, page 4P)

47 Earned Prioritized Payments, Charges, and Adjustments

48 Realized (Gains) Losses on Investments (line 28, page 4P)

49 Other (Specify)

$0 b.

Changes in Operating Assets and Liabilities Net of Noncash Items

51 (Increase) Decrease in Other Current Assets

50 (Increase) Decrease in Interest and Dividends Receivable

52 Increase (Decrease) in Accounts Payable

53 Increase (Decrease) in Accrued Interest Payable

54 Increase (Decrease) in Accrued Taxes Payable

55 Increase (Decrease) in Dividends Payable

56 Increase (Decrease) in Other Current Liabilities $0

57 Other (Specify) $0

58 Other (Specify) $0

59 NET CASH PROVIDED BY (USED IN) OPERATING ACTIVITIES $0

(Total must agree with line 14, page 5P)

Supplemental disclosure of non-cash financing and investing activities may be required.

See ASC 230, "Statement of Cash Flows".

SBA Form 468.2 (03/14) Previous edition obsolete. Page 6P

STATEMENT OF PARTNER'S CAPITAL

(Amounts rounded to the nearest dollar)

License No: 12/34-5688

PART I. PRIVATE PARTNERS' CONTRIBUTED CAPITAL

1 BALANCE AT BEGINNING OF PERIOD $0

2 ADDITIONS:

d. Capitalization of Retained Earnings Available for Distribution $0

e. Other credits (specify) $0

c. Partnership interests issued for contributed non-cash assets $0

b. Partnership interests issued for services rendered $0

a. Partnership interests issued for cash $0

General Partner(s)

(page 3P, line 46a)

Limited Partner(s) (page 3P, line

46B) Total

$0 $0

3 Total additions (sum of 2a through 2E) $0 $0 $0

4 Subtotal (line 1 plus line 3)

5 DEDUCTIONS:

a. Liquidation of Partnership interests $0 $0 $0 b.Other debits (specify) $0 $0 $0

6 Total deductions (sum of 5a through 5b) $0 $0 $0

7 BALANCE AT END OF PERIOD (line 4 minus line 6) -- Total must agree with lines 46a and 46b, page 3P

$0 $0 $0

PART II. UNDISTRIBUTED REALIZED EARNINGS NONCASH

GAINS/INCOME

(1)

UNDISTRIBUTE

D NET

REALIZED

EARNINGS (2)

UNDISTRIBUTED

REALIZED

EARNINGS (1) +

(2)

1 BALANCE AT BEGINNING OF PERIOD $0 $0 $0

2 ADDITIONS:

b. Interest Expense - Earned Prioritized Payments, Charges & Adjustments (line 11a, page4P)

a. Net investment income $0 $0 $0

$0 $0 $0

e. Other (specify)

d. Gain on appreciation of securities distributed in kind

c. Realized gain (loss) on investments $0 $0 $0

$0 $0 $0

3 Total additions (sum of 2a through 2e) $0 $0 $0

4 Subtotal (line 1 plus line 3) $0 $0 $0

5 DEDUCTIONS:

a. Cash Distributions $0 $0

b. Distributions allocated but not paid $0 $0

c. In-Kind Distributions (at fair value) $0 $0 $0

d. Capitalization of Retained Earnings available for Distribution $0 $0

e. Other (specify) $0 $0 $0

6 Total deductions (sum of 5a through 5e) $0 $0 $0

7 Total before collection of non-cash gains/income (line 4 minus line 6) $0 $0 $0

8 Collection of non-cash gains/income $0 $0

9 BALANCE AT END OF PERIOD (line 7 plus line 8) - Totals must agree with lines 49, 50, and 51, page 3P

$0 $0 $0

SBA Form 468.2 (03/14) Previous edition obsolete. Page 7P

STATEMENT OF PARTNER'S CAPITAL

AS OF 12/31/2015

(Amounts rounded to the nearest dollar)

License No: 12/34-5688

PART I. PRIVATE PARTNERS' CONTRIBUTED CAPITAL

1 BALANCE AT BEGINNING OF PERIOD $0

2 ADDITIONS:

d. Capitalization of Retained Earnings Available for Distribution $0

e. Other credits (specify) $0

c. Partnership interests issued for contributed non-cash assets $0

b. Partnership interests issued for services rendered $0

a. Partnership interests issued for cash $0

General Partner(s)

(page 3P, line 46a)

Limited Partner(s) (page 3P, line

46B) Total

$0 $0

3 Total additions (sum of 2a through 2E) $0 $0 $0

4 Subtotal (line 1 plus line 3)

5 DEDUCTIONS:

a. Liquidation of Partnership interests $0 $0 $0 b.Other debits (specify) $0 $0 $0

6 Total deductions (sum of 5a through 5b) $0 $0 $0

7 BALANCE AT END OF PERIOD (line 4 minus line 6) -- Total must agree with lines 46a and 46b, page 3P

$0 $0 $0

PART II. UNDISTRIBUTED REALIZED EARNINGS NONCASH

GAINS/INCOME

(1)

UNDISTRIBUTE

D NET

REALIZED

EARNINGS (2)

UNDISTRIBUTED

REALIZED

EARNINGS (1) +

(2)

1 BALANCE AT BEGINNING OF PERIOD $0 $0 $0

2 ADDITIONS:

b. Interest Expense - Earned Prioritized Payments, Charges & Adjustments (line 11a, page4P)

a. Net investment income $0 $0 $0

$0 $0 $0

e. Other (specify)

d. Gain on appreciation of securities distributed in kind

c. Realized gain (loss) on investments $0 $0 $0

$0 $0 $0

3 Total additions (sum of 2a through 2e) $0 $0 $0

4 Subtotal (line 1 plus line 3) $0 $0 $0

5 DEDUCTIONS:

a. Cash Distributions $0 $0

b. Distributions allocated but not paid $0 $0

c. In-Kind Distributions (at fair value) $0 $0 $0

d. Capitalization of Retained Earnings available for Distribution $0 $0

e. Other (specify) $0 $0 $0

6 Total deductions (sum of 5a through 5e) $0 $0 $0

7 Total before collection of non-cash gains/income (line 4 minus line 6) $0 $0 $0

8 Collection of non-cash gains/income $0 $0

9 BALANCE AT END OF PERIOD (line 7 plus line 8) - Totals must agree with lines 49, 50, and 51, page 3P

$0 $0 $0

SBA Form 468.2 (03/14) Previous edition obsolete. Page 7P

I.RETAINED EARNINGS AVAILABLE FOR DISTRIBUTION

II. REGULATORY AND LEVERAGEABLE CAPITAL

AS OF 12/31/2015

(Amounts rounded to nearest dollar)

3 RETAINED EARNINGS AVAILABLE FOR DISTRIBUTION OR CAPITALIZATION

2 LESS: Unrealized Depreciation (line 10, column 2, page 2P)

1 Undistributed net Realized Earnings (line 50, page 3P) $0

PART I. RETAINED EARNINGS AVAILABLE FOR DISTRIBUTION OR CAPITALIZATION.

1 Private Partners' Contributed Capital (line 46, page 3P)

PART II. SCHEDULE OF REGULATORY AND LEVERAGEABLE CAPITAL

2 ADD:

a. Unfunded binding commitments from Institutional Investors

b. Waived management fees credited as capital contributions

3 LESS: Regulatory Distributions

a. Organization Expenses Not Approved by SBA (1)

b. Partnership interests Issued for Services

c. Partnership interests Issued for Non-cash Assets (unless approved by SBA for inclusion in Regulatory Capital or converted to cash)

d. Other credits (specify)

4 Total Regulatory Deductions (Sum of 3a through 3d)

5 Other Adjustments to Regulatory Capital (specify)

6 REGULATORY CAPITAL (sum of lines 1, 2, 4, and 5)

7 LESS: Unfunded binding commitments from Institutional Investors

8 LESS: Non-cash assets included in Regulatory Capital, other than eligible investments in Small Concerns

9 LESS: Other deductions (specify)

10 LEVERAGEABLE CAPITAL (sum of lines 6 through 9)

PART III. CUMULATIVE PRIVATE INVESTOR CAPITAL CONTRIBUTIONS & DISTRIBUTIONS

(for SBICs licensed on or after January 1, 1994)

1 All Private Capital Contributions Ever Paid-In

2 All Distributions to Private Investors Ever Paid Out - Including Fair Market Value of Non-Cash Distributions

NOTES

(1) Deduct only those organizational expenses which were not accepted as reasonable by SBA.

SBA Form 468.2 (03/14) Previous edition obsolete. Page 8P

I.RETAINED EARNINGS AVAILABLE FOR DISTRIBUTION

II. REGULATORY AND LEVERAGEABLE CAPITAL

AS OF 12/31/2015

(Amounts rounded to nearest dollar)

3 RETAINED EARNINGS AVAILABLE FOR DISTRIBUTION OR CAPITALIZATION

2 LESS: Unrealized Depreciation (line 10, column 2, page 2P)

1 Undistributed net Realized Earnings (line 50, page 3P) $0

PART I. RETAINED EARNINGS AVAILABLE FOR DISTRIBUTION OR CAPITALIZATION.

1 Private Partners' Contributed Capital (line 46, page 3P)

PART II. SCHEDULE OF REGULATORY AND LEVERAGEABLE CAPITAL

2 ADD:

a. Unfunded binding commitments from Institutional Investors

b. Waived management fees credited as capital contributions

3 LESS: Regulatory Distributions

a. Organization Expenses Not Approved by SBA (1)

b. Partnership interests Issued for Services

c. Partnership interests Issued for Non-cash Assets (unless approved by SBA for inclusion in Regulatory Capital or converted to cash)

d. Other credits (specify)

4 Total Regulatory Deductions (Sum of 3a through 3d)

5 Other Adjustments to Regulatory Capital (specify)

6 REGULATORY CAPITAL (sum of lines 1, 2, 4, and 5)

7 LESS: Unfunded binding commitments from Institutional Investors

8 LESS: Non-cash assets included in Regulatory Capital, other than eligible investments in Small Concerns

9 LESS: Other deductions (specify)

10 LEVERAGEABLE CAPITAL (sum of lines 6 through 9)

PART III. CUMULATIVE PRIVATE INVESTOR CAPITAL CONTRIBUTIONS & DISTRIBUTIONS

(for SBICs licensed on or after January 1, 1994)

1 All Private Capital Contributions Ever Paid-In

2 All Distributions to Private Investors Ever Paid Out - Including Fair Market Value of Non-Cash Distributions

NOTES

(1) Deduct only those organizational expenses which were not accepted as reasonable by SBA.

SBA Form 468.2 (03/14) Previous edition obsolete. Page 8P

SCHEDULE OF COMMITMENTS AS OF 12/31/2015 OMB Approval No. 3245-0063

1 2 3 4 5 6 7

Name of Small Business Employer ID Amount of

Commitment Date Made Expiration Date Loan, Debt, or

Equity?

New investment or follow-on?

License No: 12/34-5688

Total

Expiration Date 10/31/2017

SBA Form 468.2 (03/14) Previous edition obsolete. Page 9P

SCHEDULE OF COMMITMENTS AS OF 12/31/2015 OMB Approval No. 3245-0063

1 2 3 4 5 6 7

Name of Small Business Employer ID Amount of

Commitment Date Made Expiration Date Loan, Debt, or

Equity?

New investment or follow-on?

License No: 12/34-5688

Total

Expiration Date 10/31/2017

SBA Form 468.2 (03/14) Previous edition obsolete. Page 9P

SCHEDULE OF GUARANTEES AS OF 12/31/2015 OMB Approval No. 3245-0063

1 2 3 4 5 6 7

Name of Small Business / Employer ID Guarantee

Amount Date Made Expiration Date

Name of Guaranteed Party

Is guarantee collateralized? If so, by what?

Description of underlying obligation of Small Business

Total

SBA Form 468.2 (03/14) Previous edition obsolete. Page 10P

SCHEDULE OF GUARANTEES AS OF 12/31/2015 OMB Approval No. 3245-0063

1 2 3 4 5 6 7

Name of Small Business / Employer ID Guarantee

Amount Date Made Expiration Date

Name of Guaranteed Party

Is guarantee collateralized? If so, by what?

Description of underlying obligation of Small Business

Total

SBA Form 468.2 (03/14) Previous edition obsolete. Page 10P

Portfolio Company Name Employer ID % Own % Vote Cost at End of Period Unrealized App (Dep) Total Reported Value test 99-1234567 0% 0% $0 $0 $0

Loans and Investments (ordered by date ascending)

Investment Date Investment Type Initial Invest.

Amount

Cost at Beg. of Period

Additions / Deductions

Description of Addition / Deductions Cost At End of Period

Unrealized App (Dep)

Total Reported Value

1/1/2015 Equity $0 $0 $0 01/01/2015 - Equity $0 $0 $0

Other Notes: Qualifies as start-up per CFR 107.50? No Class I and II Appreciation:

Class I Appreciation Amount: $0

Smaller Enterprise? No Equity Capital? No Class II Appreciation Amount $0

Comments: If Class II, Date of Up Round?

Equity Information: Number of Shares: Loan/Debt Information: Status:

Type of Shares: Common Stock Market /Liquidity: Maturity Date: Interest Rate:

Equity Features: 0 Repay. Terms:

Collateral :

Warrants? No Expiration Date: Date Investment Concluded:

SBA Form 468.2 (03/14) Previous edition obsolete. Page 11P-2

SCHEDULE OF LOANS AND INVESTMENTS AS OF

12/31/2015

Name of the Licensee: Test 4

SCHEDULE 1 OMB Approval No. 3245-0063 Expiration Date 10/31/2017

License No. 12/34-5688

Portfolio Company Name Employer ID % Own % Vote Cost at End of Period Unrealized App (Dep) Total Reported Value test 99-1234567 0% 0% $0 $0 $0

Loans and Investments (ordered by date ascending)

Investment Date Investment Type Initial Invest.

Amount

Cost at Beg. of Period

Additions / Deductions

Description of Addition / Deductions Cost At End of Period

Unrealized App (Dep)

Total Reported Value

1/1/2015 Equity $0 $0 $0 01/01/2015 - Equity $0 $0 $0

Other Notes: Qualifies as start-up per CFR 107.50? No Class I and II Appreciation:

Class I Appreciation Amount: $0

Smaller Enterprise? No Equity Capital? No Class II Appreciation Amount $0

Comments: If Class II, Date of Up Round?

Equity Information: Number of Shares: Loan/Debt Information: Status:

Type of Shares: Common Stock Market /Liquidity: Maturity Date: Interest Rate:

Equity Features: 0 Repay. Terms:

Collateral :

Warrants? No Expiration Date: Date Investment Concluded:

SBA Form 468.2 (03/14) Previous edition obsolete. Page 11P-2

SCHEDULE OF LOANS AND INVESTMENTS AS OF

12/31/2015

Name of the Licensee: Test 4

SCHEDULE 1 OMB Approval No. 3245-0063 Expiration Date 10/31/2017

License No. 12/34-5688

1 A. SUMMARY OF LOANS AND INVESTMENTS 1 B.

SMALLER ENTERPRISE FINANCINGS AS OF

12/31/2015

SCHEDULE 1 A/B

Expiration Date 10/31/2017

1 2 3 4 5 6

Investment Category Cost at Beginning of Period Additions/

(Deductions) Cost at End of

Period

Unrealized Appreciation

(Depreciation) Reported Value

Total Loans (line1, page 2P) $0 $0 $0 $0 $0

Total Debt Securities (line 2, page 2P) $0 $0 $0 $0 $0

Total Equity Securities (line 3, page 2P) $0 $0 $0 $0 $0

Total Portfolio Securities (line 4, page 2P) $0 $0 $0 $0 $0

Total Assets Acquired (line 7, page 2P) $0 $0 $0 $0 $0

Total Operating Concerns Acquired (line 8, page 2P) $0 $0 $0 $0 $0

Total Notes and Other Secs. Received (line 9, page 2P) $0 $0 $0 $0 $0

Total Loans and Investments (line 10, page 2P) $0 $0 $0 $0 $0

1 A. SUMMARY OF LOANS AND INVESTMENTS

1 B. SMALLER ENTERPRISE FINANCINGS

1 Cumulative dollar amount of Smaller Enterprise Financings extended between April 25, 1994 and close of reporting fiscal year.

2 Cumulative dollar amount of all Financing extended between April 25, 1994 and close of reporting fiscal year.

3 Percentage of total Financings extended to Smaller Enterprises (line 1 divided by line 2)

0.00%

SEE 13 CFR 107.710 FOR PERCENTAGE OF TOTAL FINANCINGS WHICH MUST BE IN SMALLER ENTERPRISES.

License No: 12/34-5688

SBA Form 468.2 (03/14) Previous edition obsolete. Page 12P

1 A. SUMMARY OF LOANS AND INVESTMENTS 1 B.

SMALLER ENTERPRISE FINANCINGS AS OF

SCHEDULE 1 A/B

Expiration Date 10/31/2017

1 2 3 4 5 6

Investment Category Cost at Beginning of Period Additions/

(Deductions) Cost at End of

Period

Unrealized Appreciation

(Depreciation) Reported Value

Total Loans (line1, page 2P) $0 $0 $0 $0 $0

Total Debt Securities (line 2, page 2P) $0 $0 $0 $0 $0

Total Equity Securities (line 3, page 2P) $0 $0 $0 $0 $0

Total Portfolio Securities (line 4, page 2P) $0 $0 $0 $0 $0

Total Assets Acquired (line 7, page 2P) $0 $0 $0 $0 $0

Total Operating Concerns Acquired (line 8, page 2P) $0 $0 $0 $0 $0

Total Notes and Other Secs. Received (line 9, page 2P) $0 $0 $0 $0 $0

Total Loans and Investments (line 10, page 2P) $0 $0 $0 $0 $0

1 A. SUMMARY OF LOANS AND INVESTMENTS

1 B. SMALLER ENTERPRISE FINANCINGS

1 Cumulative dollar amount of Smaller Enterprise Financings extended between April 25, 1994 and close of reporting fiscal year.

2 Cumulative dollar amount of all Financing extended between April 25, 1994 and close of reporting fiscal year.

3 Percentage of total Financings extended to Smaller Enterprises (line 1 divided by line 2)

0.00%

SEE 13 CFR 107.710 FOR PERCENTAGE OF TOTAL FINANCINGS WHICH MUST BE IN SMALLER ENTERPRISES.

License No: 12/34-5688

SBA Form 468.2 (03/14) Previous edition obsolete. Page 12P

SCHEDULE OF REALIZED GAINS AND LOSSES ON

LOANS AND INVESTMENTS FOR 12 MONTHS ENDED

Name of the Licensee:

Schedule 2

Expiration Date 10/31/2017

1 2 3 4 5 6 7 8 9 10

Components of Net Sales Price

Name of Small Business / Employer ID

Security Type (1)

Transaction Type (2) /

Date Net Sales

Price Cost Realized

Gains / (Loss) Cash

Note/ Maturity

Date Equity / Type

Name and Address of Purchaser (applies to sales and exchanges)

Escrow Exp. Comments :

Total

License No: 12/34-5688Test 4

SBA Form 468.2 (03/14) Previous edition obsolete. Page 13P

(1) Security Type: L= Loans, D=Debt, E=Equity, AA=Assets Acquired, OC=Operating concerns acquired, NS=Notes and Other Securities Received

(2) Transaction Type: S= Sale, E=Exchange, C=Charge-off, D=Distribution of Securities

SCHEDULE OF REALIZED GAINS AND LOSSES ON

LOANS AND INVESTMENTS FOR 12 MONTHS ENDED

Name of the Licensee:

Schedule 2

Expiration Date 10/31/2017

1 2 3 4 5 6 7 8 9 10

Components of Net Sales Price

Name of Small Business / Employer ID

Security Type (1)

Transaction Type (2) /

Date Net Sales

Price Cost Realized

Gains / (Loss) Cash

Note/ Maturity

Date Equity / Type

Name and Address of Purchaser (applies to sales and exchanges)

Escrow Exp. Comments :

Total

License No: 12/34-5688Test 4

SBA Form 468.2 (03/14) Previous edition obsolete. Page 13P

(1) Security Type: L= Loans, D=Debt, E=Equity, AA=Assets Acquired, OC=Operating concerns acquired, NS=Notes and Other Securities Received

(2) Transaction Type: S= Sale, E=Exchange, C=Charge-off, D=Distribution of Securities

SCHEDULE OF NONCASH GAINS/INCOME as of

Schedule 3 Expiration Date 10/31/2017

1 2 3 4 5 6 7

Name of Small Business / Employer ID

Description of Non-cash Gains / Income (1)

Balance at Beginning of

Period Additions Collections

During Period Balance at End of

Period Amount of "Includible Non-cash

Gains" for Capital Impairment

License No: 12/34-5688

Total

SBA Form 468.2 (03/14) Previous edition obsolete. Page 14P

(1) Examples of non-cash gains and income include the following:

- Non-cash gains on sale or exchange of securities

- Interest income accrued on deferred interest notes, zero coupon bonds or similar instruments

- Dividends received in kind

- Accrued interest converted into a new note or added to principal of an existing note. The amount of any such interest which was previously included in Undistributed Net Realized Earnings must be reclassified to Non-cash Gains/Income.

SCHEDULE OF NONCASH GAINS/INCOME as of

Schedule 3 Expiration Date 10/31/2017

1 2 3 4 5 6 7

Name of Small Business / Employer ID

Description of Non-cash Gains / Income (1)

Balance at Beginning of

Period Additions Collections

During Period Balance at End of

Period Amount of "Includible Non-cash

Gains" for Capital Impairment

License No: 12/34-5688

Total

SBA Form 468.2 (03/14) Previous edition obsolete. Page 14P

(1) Examples of non-cash gains and income include the following:

- Non-cash gains on sale or exchange of securities

- Interest income accrued on deferred interest notes, zero coupon bonds or similar instruments

- Dividends received in kind

SCHEDULE OF DELINQUENT LOANS AND

INVESTMENTS AS OF 12/31/2015

Schedule 4

Expiration Date 10/31/2017

(1) Based on oldest delinquency.

1 2 3 4 5 6 7 8 9 10 11

Delinquent Principal: Delinquent Interest Date of Last Payment Amount of Last Payment

Name of Small Business / Employer ID

Outstanding Principal Balance

Amount Past Due

Days Past Due (1)

Amount Past Due

Days Past Due (1) Principal Interest Principal Interest

Fair Market Value of Collateral

Total

SBA Form 468.2 (03/14) Previous edition obsolete. Page 15P

SCHEDULE OF DELINQUENT LOANS AND

INVESTMENTS AS OF 12/31/2015

Schedule 4

Expiration Date 10/31/2017

(1) Based on oldest delinquency.

1 2 3 4 5 6 7 8 9 10 11

Delinquent Principal: Delinquent Interest Date of Last Payment Amount of Last Payment

Name of Small Business / Employer ID

Outstanding Principal Balance

Amount Past Due

Days Past Due (1)

Amount Past Due

Days Past Due (1) Principal Interest Principal Interest

Fair Market Value of Collateral

Total

SBA Form 468.2 (03/14) Previous edition obsolete. Page 15P

SCHEDULE OF CASH AND INVESTED IDLE FUNDS

OMB Approval No. 3245-0063

Name of the Licensee: Test 4 License No: 12/34-5688

Schedule 5 Expiration Date 10/31/2017

COMPLETE SCHEDULE ONLY IF LICENSEE HAS, OR PLANS TO APPLY FOR, SBA LEVERAGE.

I. U.S. GOVERNMENT OBLIGATIONS (direct or guaranteed)

Description Maturity Date Amount

II. REPURCHASE AGREEMENTS WITH FEDERALLY-INSURED INSTITUTION

Name and Location of Financial Institution Maturity Date Amount

III. CERTIFICATES OF DEPOSIT ISSUED BY FEDERALLY-INSURED INSTITUTIONS

Name and Location of Financial Institution Maturity Date Amount

IV. DEMAND DEPOSIT, MONEY MARKET, AND SAVING ACCOUNTS IN FEDERALLY-INSURED INSTITUTIONS

Name and Location of Financial Institution Maturity Date Amount

V. OTHER CASH AND INVESTED IDLE FUNDS

Description Maturity Date Amount

TOTAL CASH, CASH EQUIVALENTS AND IDLE FUNDS

(total must agree with sum of lines 14 and 15, page 2P)

SBA Form 468.2 (03/14) Previous edition obsolete. Page 16P

SCHEDULE OF CASH AND INVESTED IDLE FUNDS

AS OF 12/31/2015

OMB Approval No. 3245-0063

Name of the Licensee: Test 4 License No: 12/34-5688

Schedule 5 Expiration Date 10/31/2017

COMPLETE SCHEDULE ONLY IF LICENSEE HAS, OR PLANS TO APPLY FOR, SBA LEVERAGE.

I. U.S. GOVERNMENT OBLIGATIONS (direct or guaranteed)

Description Maturity Date Amount

II. REPURCHASE AGREEMENTS WITH FEDERALLY-INSURED INSTITUTION

Name and Location of Financial Institution Maturity Date Amount

III. CERTIFICATES OF DEPOSIT ISSUED BY FEDERALLY-INSURED INSTITUTIONS

Name and Location of Financial Institution Maturity Date Amount

IV. DEMAND DEPOSIT, MONEY MARKET, AND SAVING ACCOUNTS IN FEDERALLY-INSURED INSTITUTIONS

Name and Location of Financial Institution Maturity Date Amount

V. OTHER CASH AND INVESTED IDLE FUNDS

Description Maturity Date Amount

TOTAL CASH, CASH EQUIVALENTS AND IDLE FUNDS

(total must agree with sum of lines 14 and 15, page 2P)

SBA Form 468.2 (03/14) Previous edition obsolete. Page 16P

SCHEDULE OF ACTIVITY AS OF 12/31/2015 OMB Approval No. 3245-0063

Schedule 6 Expiration Date 10/31/2017

PART I. FIRST ACTIVITY TEST

2. Invested Idle Funds (line 15, line 2P)

1. Cash and Cash Equivalents (line 14, page 2P) $0

3. Total Cash and Idle Funds

4. Total Assets at Cost:

a. Total Assets (line 30, page 2P)

b. ADD: Unrealized Depreciation (line 10, col. 2, page 2P)

c. LESS: Unrealized Appreciation (line 10, col 3, page 2P)

d. Total Assets at Cost

5. Line 3 Divided by Line 4d (expressed as a percentage)

IF LINE 5 IS LESS THAN OR EQUAL TO 20%, LICENSEE IS NOT INACTIVE -- DO NOT COMPLETE PART II

IF LINE 5 IS GREATER THAN 20%, COMPLETE THE SECOND ACTIVITY TEST IN PART II

PART II. SECOND ACTIVITY TEST

6. Financings during the Past 18 Months:

a. Loans

b. Debt

c. Equity

d. Guarantees

7. Total (lines 6a through 6d)

9. Line 7 divided by Line 8 (expressed as a percentage)

8. Regulatory Capital

IF LINE 9 IS LESS THAN 20%, LICENSEE MAY BE INACTIVE UNDER SECTION 107.590 -

ATTACH EXPLANATION OF INACTIVITY AND PLANNED CORRECTIVE ACTION.

SBA Form 468.2 (03/14) Previous edition obsolete. Page 17P

SCHEDULE OF ACTIVITY AS OF 12/31/2015 OMB Approval No. 3245-0063

Schedule 6 Expiration Date 10/31/2017

PART I. FIRST ACTIVITY TEST

2. Invested Idle Funds (line 15, line 2P)

1. Cash and Cash Equivalents (line 14, page 2P) $0

3. Total Cash and Idle Funds

4. Total Assets at Cost:

a. Total Assets (line 30, page 2P)

b. ADD: Unrealized Depreciation (line 10, col. 2, page 2P)

c. LESS: Unrealized Appreciation (line 10, col 3, page 2P)

d. Total Assets at Cost

5. Line 3 Divided by Line 4d (expressed as a percentage)

IF LINE 5 IS LESS THAN OR EQUAL TO 20%, LICENSEE IS NOT INACTIVE -- DO NOT COMPLETE PART II

IF LINE 5 IS GREATER THAN 20%, COMPLETE THE SECOND ACTIVITY TEST IN PART II

PART II. SECOND ACTIVITY TEST

6. Financings during the Past 18 Months:

a. Loans

b. Debt

c. Equity

d. Guarantees

7. Total (lines 6a through 6d)

9. Line 7 divided by Line 8 (expressed as a percentage)

8. Regulatory Capital

IF LINE 9 IS LESS THAN 20%, LICENSEE MAY BE INACTIVE UNDER SECTION 107.590 -

ATTACH EXPLANATION OF INACTIVITY AND PLANNED CORRECTIVE ACTION.

SBA Form 468.2 (03/14) Previous edition obsolete. Page 17P

GENERAL PARTNERS, LIMITED PARTNERS,

AND ADVISORY MANAGEMENT

Schedule 7 Expiration Date 10/31/2017

1 2 3 4 5

Percent Owned or Controlled of Total Interests Outstanding

Name and Address

General Partner / Limited Partner / Manager -- give exact titles

Are partnership interests legally owned, beneficially owned, or controlled?

Number of Partnership

Units Owned or Controlled

Beginning of Period End of Period

SBA Form 468.2 (03/14) Previous edition obsolete. Page 18P

GENERAL PARTNERS, LIMITED PARTNERS,

AND ADVISORY MANAGEMENT

Schedule 7 Expiration Date 10/31/2017

1 2 3 4 5

Percent Owned or Controlled of Total Interests Outstanding

Name and Address

General Partner / Limited Partner / Manager -- give exact titles

Are partnership interests legally owned, beneficially owned, or controlled?

Number of Partnership

Units Owned or Controlled

Beginning of Period End of Period

SBA Form 468.2 (03/14) Previous edition obsolete. Page 18P

OPERATING PLAN UPDATE OMB Approval No. 3245-0063

Expiration Date 10/31/2017

INSTRUCTIONS

Any Licensee, which has SBA leverage outstanding or which expects to apply for leverage in the current fiscal year, must prepare an annual update of its plan of operations. The update must be submitted to SBA as an addenum to the Licensee's Annual Financial Report on Form 468.

SBA will consider the information provided as part of its evaluation of the financial soundness of the Licensee, in accordance with the provisions of Section 406 of the Small Business Equity Enhancement Act.

The plan update must include analysis and discussion of key events of the past year, as well as expectations for the current year. SBA expects that most Licensees will be able to provide the required information in a narrative of no more than 3 pages.

Content of the Report

1. For the fiscal year ended, the Licensee should discuss the following:

a. Major positive and negative events which affected overall performance during the year, including exits / distributions / write- offs of investments; highlight any significant differences between last year's plan and actual performance.

b. Any significant changes in the operations of the Licensee, such as changes in organizational structure, scope of operations, level or phase of investment activity, or types of investments being made.

c. Any management changes.

d. Any lawsuits or other events giving rise to contingent liabilities.

2. For the current fiscal year, the Licensee should discuss the following:

a. Levels of new and follow-on investment anticipated

b. Anticipated exits/distributions/write-offs from investments

c. Any material changes expected in investment strategy or portfolio composition

d. Any material changes expected in overhead expenditures

e. Any changes expected in management

f. Any other anticipated events which may have a significant effect on Licensee's performance.

3. If an SBIC is in Liquidation, wind-up or has been otherwise requested to provide a wind-up plan, the SBIC shall provide a wind-up plan as part of the Operating Plan Update. Per 13 CFR 107.590, SBICs in Operations must submit wind-up plans for SBA approval. After SBICs receive approval, they should provide updated windup plans on an annual basis as part of this Operating Plan Update. (See attached supplement.)

SBA Form 468.2 (03/14) Previous edition obsolete. Page 19P

OPERATING PLAN UPDATE OMB Approval No. 3245-0063

Name of the Licensee: Test 4 License No: 12/34-5688

Expiration Date 10/31/2017

INSTRUCTIONS

Content of the Report

1. For the fiscal year ended, the Licensee should discuss the following:

c. Any management changes.

d. Any lawsuits or other events giving rise to contingent liabilities.

2. For the current fiscal year, the Licensee should discuss the following:

a. Levels of new and follow-on investment anticipated

b. Anticipated exits/distributions/write-offs from investments

c. Any material changes expected in investment strategy or portfolio composition

d. Any material changes expected in overhead expenditures

e. Any changes expected in management

f. Any other anticipated events which may have a significant effect on Licensee's performance.

SBA Form 468.2 (03/14) Previous edition obsolete. Page 19P

Portfolio Company Name Employer ID % Own % Vote Cost at End of Period Unrealized App (Dep) Total Reported Value test 99-1234567 0% 0% $0 $0 $0

General Portfolio Company Information

Soybean farming, field and seed production

111110NAICS:

1st Date Invested:

Current Stage: Seed

Overline? No

Exchange: Stock Symbol:

If original investment company's name changed, was acquired/merged, company name of original investment:

Address: 111 test Dr

City/State: Test City / Alabama

Zip Code: 12345 LMI:

Other Comments:

Business Description:

Portfolio Company Financial InformationRounded to nearest $

Gross Profit

Revenues

As Of Date

EBITDA

Interest Charges

Net Income

Cashflow from Ops.

Burn Rate

Cash Balance

Current Assets

Fixed Assets

Total Assets

Current Liabilities

Debt

Total Liabilities

EOY Equity Value (Market)

EOY Enterprise Value

Period 1 Period 2 Period 3

$0 $0$0

Full-time employees : -

Federal Taxes Paid : $0 State Taxes Paid : $0

Fiscal Year End:

Basis Period

SBA Form 468.2 (03/14) Previous edition obsolete. Page 20P

Unaudited Portfolio Company Information

SCHEDULE 8

License No. 12/34-5688 Expiration Date 10/31/2017

Portfolio Company Name Employer ID % Own % Vote Cost at End of Period Unrealized App (Dep) Total Reported Value test 99-1234567 0% 0% $0 $0 $0

General Portfolio Company Information

Soybean farming, field and seed production

111110NAICS:

1st Date Invested:

Current Stage: Seed

Overline? No

Exchange: Stock Symbol:

If original investment company's name changed, was acquired/merged, company name of original investment:

Address: 111 test Dr

City/State: Test City / Alabama

Zip Code: 12345 LMI:

Other Comments:

Business Description:

Portfolio Company Financial InformationRounded to nearest $

Gross Profit

Revenues

As Of Date

EBITDA

Interest Charges

Net Income

Cashflow from Ops.

Burn Rate

Cash Balance

Current Assets

Fixed Assets

Total Assets

Current Liabilities

Debt

Total Liabilities

EOY Equity Value (Market)

EOY Enterprise Value

Period 1 Period 2 Period 3

$0 $0$0

Full-time employees : -

Federal Taxes Paid : $0 State Taxes Paid : $0

Fiscal Year End:

Basis Period

SBA Form 468.2 (03/14) Previous edition obsolete. Page 20P

Unaudited Portfolio Company Information

SCHEDULE 8

License No. 12/34-5688

UNAUDITED SBIC CUMULATIVE INVESTMENT

PERFORMANCE AS OF 12/31/2015

SCHEDULE 9

Expiration Date 10/31/2017

Include all investments, both realized and unrealized, made by the SBIC since the fund commencement date or October 1, 1993, whichever is later. If historical information is unavailable in the format requested, you may omit (1) investments realized or written off on or before June 30, 2011, and (2) for investments held as of July 1, 2011, gross receipts received on or before June 30, 2011.

1 2 3 4 5 6 7 8 9 10

Gross Receipts*

Name of Small Business Employer ID Date 1st Invested

Total Dollars Invested Cash Equity Total

SBA Reported Value

Gross Receipts to Total Dollars

Invested

(Gross Receipts + Reported

Value) to Total Dollars

Invested test 99-1234567 $0 $0 $0 $0 0.00 0.00

TOTAL $0 $0 $0 $0 0.00 0.00

SBA Form 468.2 (03/14) Previous edition obsolete. Page 21P

* Note: Gross Receipts includes all cash and qualifying equity securities received by SBIC for portfolio company investment. Cash receipts may include interest, dividends, repayment of debt, profit distributions, etc?

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