Mason Micro-business Grant Application

Mason Loan Application Questions
I have read the FAQs and guidelines before completing this application *
You must be LMI (Low-to-moderate income) in order to qualify *
Your business must be in Mason County in order to qualify. *

Owner Information

Total Household Income is gross income (before deductions) from all sources of income (wages, child support, SSI, unemployment, pension, income from assets, etc.), from all adult family and non-family members in the household.
Owner's Address *
Owner's Address
City
State/Province
Zip/Postal

2nd owner

Total Household Income is gross income (before deductions) from all sources of income (wages, child support, SSI, unemployment, pension, income from assets, etc.), from all adult family and non-family members in the household.
Owner's Address
Owner's Address
City
State/Province
Zip/Postal

3rd Owner

Total Household Income is gross income (before deductions) from all sources of income (wages, child support, SSI, unemployment, pension, income from assets, etc.), from all adult family and non-family members in the household.
Owner's Address
Owner's Address
City
State/Province
Zip/Postal

4th Owner

Total Household Income is gross income (before deductions) from all sources of income (wages, child support, SSI, unemployment, pension, income from assets, etc.), from all adult family and non-family members in the household.
Owner's Address
Owner's Address
City
State/Province
Zip/Postal

What is the address of the business? *
What is the address of the business?
City
State/Province
Zip/Postal
Is the business woman/minority owned? *
What commissioner district within Mason County the business is in
(e.g. sole proprietor, partnership, S-Corps, LLC, Contractor, etc)
(debt:income ratio is all your monthly debt payments divided by your gross monthly income. For example, if your monthly gross income (your income before expenses) equals $5,000 and your monthly recurring debts are $1,000 you would figure your debt:income ratio this way: $1,000/$5,000 = .2 X 100 = 20%. Your debt:income ratio is 20%.)
*Awardees of the forgivable loan will be required to provide receipts or cancelled checks for things purchased with the loan money.
Has the business applied for other CDBG emergency grants or forgivable loans? *
Have any been awarded to the business? *
Have you participated in any CDBG funded trainings (like those offered by Enterprise for Equity)? *
Were you forced to shutter your business? *
Were you able to keep your business open to some extent? *

Please upload these documents as either a .pdf, .jpg, or .png file.

A copy of your 2019 balance sheet *
Maximum upload size: 209.72MB
Copies of all of your monthly profit and loss statements for 2019 *
Maximum upload size: 209.72MB
March/April 2020 Profit and loss statements *
Maximum upload size: 209.72MB
Outstanding invoices (your accounts payable)
Maximum upload size: 209.72MB
Business is not a franchise, chain or MLM *
Business is not engaged in any activity that is illegal under federal, state or local law *
Applicant or any owner is not presently suspended, debarred, proposed for debarment, declared ineligible, voluntarily excluded from participation in this transaction by any Federal department or agency, or presently involved in any bankruptcy *
The business or business owner is not delinquent in any city, state or federal taxes; child support; or other penalties. *
You will receive a confirmation email with your responses to this application.
Applicant Certification: 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.