SBA EIDL SUBMISSION FORM Question Title * 1. Do You agree to give HME Consulting Inc the authorization to collect and submit your information for EIDL SBA grant? Question Title * 2. What is your Legal Name Question Title * 3. Address Name / Name of Business Company Address Address 2 City/Town State/Province ZIP/Postal Code Country Email Address Phone Number Question Title * 4. Identification D.O.B SSN: Date started mm/dd/yyyy Estimated gross income Question Title * 5. Please describe the nature of your business and services you provide. Type of Business Services provided/ Product Question Title * 6. PLEASE NOTE THAT YOU ARE APPLYING FOR A SMALL BUSINESS/ INDEPENDENT CONTRACTOR GRANT ( NOT TO PAID BACK)CLICK the box to the left of each statement to show you agree & understand. I understand this is to apply for a GRANT. I understand I DO NOT have to pay the GRANT back. Upon Receipt of the GRANT, I agree to pay HME a $50 consulting fee within 2 business days of Funding. I understand I may offered an ADDITION Small Business loan at low interest rate & low monthly payment. I understand that the loan will be at a low interest rate & low monthly payment rate. I understand I DO NOT have to ACCEPT the loan. If I do ACCEPT the SBA LOAN , I can use the loan for business expenses. (Ex; start up costs, payroll) If I do ACCEPT the loan, I agree to pay HME Consulting an Advisory fee of 3% within 2 Business days of Funding. I agree to a complimentary ( highly recommend) Business Consultation within 10 business days of my approval. While we do all diligence to maintain personal information as confidential and private, we cannot guarantee such security. Thus HME Consulting is NOT responsible nor liable for any damages sustained through this or any other transactions connected to or stemming from this business engagement. ( Please check the box to agree) Question Title * 7. CHECK IF INTERESTED IN ADDITIONAL SERVICES. Business Planning Consult Business Structure & Start up Plan Taxation & Auditing Consult Non for Profit (501c3) status Financial Literacy & Coaching Wealth Management & Investment Products Additional Funding & Financing Options SUBMIT