Taylor, MI

Eligibility Requirements

Pre-Application: Small Business Relaunch Program
Please answer the questions below to determine if your business is eligible for consideration for the Small Business Relaunch Grant Program.
1. Was your business licensed in Taylor as of February 29, 2020?
2. Did you employ 25 or fewer full-time employees as of February 29, 2020?*
3. Do 90% of your full-time and/or part-time employees earn a salary of $44,000 or less annually?*
4. Has your business experienced income loss as a result of COVID-19 related shutdowns?*
5. Are your Personal Property and Property taxes current through 2019?*
6. Can you verify that your business has received less than $7,500 in COVID-19-related grants from other sources? *
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Business Information

Business Name*
Business Address*
Business Tax ID*
Business DUNS Number*
Business Owner Name*
Business Owner Address*
Business Owner City*
Business Order Zip Code*
Business Owner Phone Number*
Business Owner Email *
Business Type*
Select Only One
If you selected "other", please explain:*
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Financial Information

Please provide the Financial information requested below. Incomplete applications will not receive consideration.
Please provide tax returns for the tax years 2018 and 2019. If an extension request was filed and granted by the Internal Revenue Service, please provide proof of extension. Based on business type, see below for the appropriate forms that are necessary for consideration.
Sole Proprietor - Form 1040
C Corporation - Form 1120
Subchapter S - Form 1120S
LLC - Form 1120 S or Form 1065
LLP - Form 1065
What was your revenue for the month of January 2020? *
What was your revenue for the month of February 2020? *
What was your revenue for the month of March 2020? *
What was your revenue for the month of April 2020? *
What was your revenue for the month of May 2020? *
What is your 2020 CY revenue loss estimate through May 31st, 2020? *
Do you own or lease the building where your business resides? *
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Employment Information

Please provide the Employment information requested below. Incomplete applications will not receive consideration.
How many employees did your business employ as of December 31, 2019?
Full-time:*
Part-time:*
Owner(s):*
Total Number of Employees*
How many employees does your business employ as of June 30, 2020?
Full-time:*
Part-time:*
Owner(s):*
Total Number of Employees:*
Please provide explanation for any workforce Changes (plus or minus) as a result of the COVID-19 pandemic.*
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Summary of COVID-19 Impact

Please provide a written summary of how your business was negatively impacted by the COVID-19 Executive Order 2020-20. What is your greatest need in order to relaunch your small business?
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Conflict of Interest

Acknowledgement of Conflict of Interest Provision and Disclosure of No Conflict
I,
Name*
applicant/recipient of certain Community
Community Development Block Grant (CDBG) funds through the City of Taylor Small Business Relaunch Grant do attest and certify that I have read and understand the following CONFLICT OF INTEREST PTOVISION:
(A) Conflicts prohibited. Except for the use of CDBG funds to pay salaries that no person described in paragraph (B) of this section who exercise or have exercised any functions or responsibilities with respect to CDBG activities assisted under this part or who are in a position to participate in a decision making processor gain inside information with regard to such activities, may obtain a personal or financial interest or benefit from a CDBG assisted activity, or have an interest in any contract, subcontract or agreement with respect thereto, or the process thereunder, either for themselves or those with whom they have family or business time, during their tenure or for one year thereafter.
(B) Persons Covered. The conflict of interest provisions of Paragraph (A) of this section apply to any person who is an employee, agent, consultant, officer, or elected official or appointed official of the recipient, or of the designated public agencies, or subrecipients which are receiving funds under this part.
(C) I further attest under the penalty of perjury that I am not an employee, agent, consultant, officer or elected official or appointed official nor am I the spouse, child, parent, brother or sister or in-law of the first degree of consanguinity with any of the individuals outlined in Paragraph (C) above pursuant to 24 CFR 570.610, et. Seq.
Electronic Signature Agreement*
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. Please review the City's website privacy policy.
1. I agree.
Electronic Signature*
Date*
Date
Date
Electronic Signature*
Date*
Date
Date
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Certifications

I certify that the information provided in this application as well as information contained within any and all documents required to be submitted as part of this application are true and accurate under penalty of perjury. I have submitted copies of all required documents as part of this application submission.
Business Owner Name:*
Electronic Signature*
Date*
Date
Date
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Small Business Relaunch Program Application

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Eligibility Requirements

Business Information

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Summary of COVID-19 Impact

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