Small Business Grant Application

  • GENERAL CONTACT INFORMATION
  • MM slash DD slash YYYY
  • BUSINESS INFORMATION
  • GRANT INFORMATION
  • Itemized List of Expected Expenses from January 1-June 30, 2021, Seeking to Be Reimbursed :
  • Rent/mortgage payment
  • Utilities
  • General Business Insurance
  • TOTAL ANTICIPATED EXPENSES:
  • 50% of EXPENSES APPLIED TO GRANT REQUEST
  • Please upload third-party documentation (i.e. mortgage statements, lease statements, utility bills, general business insurance bills, etc.) Third-party documentation should support calculation of expected 2021 eligible expenses and documentation of similar expenses in 2020 to verify reasonableness of future expenses.
  • Drop files here or
    Max. file size: 100 MB.
      DROP OR SELECT FILES
    • COMMITMENT TO REMAIN IN BUSINESS