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* 1. Contact Information:

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* 2. Business Information:

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* 3. What are the impacts to your business due to COVID-19 (check all that apply)?

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* 4. Number of employees before COVID-19:

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* 5. Gross annual revenue before COVID-19:

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* 6. Grant amount you are applying for:

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* 7. If applicable, provide the percentage (%) of change in revenue by comparing last month 2019 revenue with last month revenue 2020.

((2019 rev - 2020 rev) / 2019 rev) x 100 = % in change

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* 8. What is your plan to stabilize and continue your business during and after the stay-in-place order?

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* 9. Are you investing your own funds to support your business? If yes, how much?

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* 10. Will you be applying for the Economic Injury Disaster Loan or the Paycheck Protection Program loan offered by the federal stimulus package through the CARES Act (check all that apply)?

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* 11. Are you current with all financial obligations (rent, utilities, sales tax remittance, etc.)?
If not, please provide a list of obligations that are not current along with the duration of the delinquency.

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* 12. Any other comments you would like to share?

0 of 12 answered
 

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