CITY OF SHELTON SMALL BUSINESS COVID19 RELIEF GRANT

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Industry Sector *
 

BUSINESS QUALIFICATIONS

Was the business temporarily closed or services reduced by official order? *
Was your business impacted by COVID-19 resulting in a revenue loss of 25% or more from one year previous? *
What is the likelihood of the business permanently closing? *
Has your business received funding from either private entity, state, county or federal government in relation to COVID-19? *
If your business has received funding, list type of funding received and amounts of funding received.
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DOCUMENTATION OF EXPENSES

Expense Date Range: Expenses must be from March 15, 2020 - September 1, 2020. This is a reimbursment grant which means that your expense submissions must be already paid.

Allowable Expenses: Funding can be used towards consulting, marketing, training, operational expenses: such as rent, supplies/inventory, utility bills, etc. Operating expenses are eligible for reimbursement. Please consult with the EDC if an expense is not on this list.

Unallowable Expenses: Payroll cannot be reimbursed via this grant program. Please direct all payroll needs to Employment Security Department. The following expenses are not eligible: capitalized equipment, travel, office equipment, and computer software.

Expense Breakdown *
 Date of ExpenseMerchant NameAmount
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7
Is the businesses' LNI account current? *

ADDITIONAL INFORMATION

Ethnicity *
Race (select one) *
Female Head of Household *
Office of Minority or Women's Business Enterprise certified *
Currently, is the business facing any pending litigation or legal action? *
Has the business had any state compliance/regulatory issues within Washington or another state in which the business operated? *
I certify the information given on this form is true and accurate to the best of my knowledge. I am aware there are penalties for willfully and knowingly giving false information. I authorize data verification by federal, state and local government representatives and will provide supporting documentation required (e.g. payroll records, tax fillings, bank account statements, etc.), if necessary. *
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