[City of Takoma Park] 2022 SBG

Section 1 of 1 in this document

Grant Application

The City of Takoma Park is awarding grant funding to support local small businesses as the economy continues to recover from the ongoing COVID-19 pandemic. If you are interested in applying for a grant and meet all the eligibility requirements, please complete and submit the application below. Grant information, including eligibility requirements, can be found here. If you have any questions or need assistance completing the application, please contact the City of Takoma Park at 301-891-7119 or econdev@takomaparkmd.gov. The deadline for application submission is Friday, April 15, 2022 at 11:59pm.

Business Legal Name

Business Common Name

Business Website

Primary Owner Name

Primary Owner Phone Number

Primary Owner E-Mail

Primary Language(s) Spoken

English

Spanish

Amharic

French

Business Legal Structure

Type of Business (ex. Food Service, Auto, Beauty/Salon, etc.)

Business Description

Year Business Opened

Business Ownership - Local Resident

Business Ownership - Racial Identity

American Indian or Alaska Native

Asian

Black, African-American, or African Descent

Hispanic or Latinx

White

Multi-Racial

Other/Choose Not to Identify

Other Minority-Ownership Status(es)

Estimated Number of Full-Time Employees

Estimated Number of Part-Time/Seasonal Employees

2021 Business Annual Gross Revenue

Please upload documentation to verify your 2021 annual gross revenue. This documentation could include bank statements, POS system revenue reports, profit & loss statements, etc.

2021 Annual Gross Revenue Documentation

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2020 Business Annual Gross Revenue

Please upload your 2020 Business Tax Return with all schedules. Sole-proprietors or self-employed applicants may submit a 2020 Personal Income Tax Return with a Schedule C included.

*** If your business was not in operation in 2020, enter "$0" for your 2020 Business Annual Gross Revenue

2020 Tax Return Documentation

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Other Relief Funds Received During the COVID-19 Pandemic (select all that apply)

City of Takoma Park Relief Funds

Montgomery County Relief Funds

State of Maryland Relief Funds (MD COVID-19 Emergency Grant or Loan)

Federal Relief Funds (PPP, EIDL, Restaurant Revitalization)

Other Relief Funds (foundation or business association funding, etc.)

No Relief Funds Received

Estimated Total of COVID-19 Relief Funds Received

File Upload Disclaimer

By checking this box, I acknowledge that I am authorized to provide this information, and release the City of Takoma Park from any liability that may result from the upload of documents through this application.

Eligibility Criteria Acknowledgement

I have reviewed the Eligibility Criteria for this grant found at: https://takomaparkmd.gov/government/housing-and-community-development/economic-development/takoma-park-small-business-support-grant/

Sign here to submit your application

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

Business Address