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Personal Information
Name
*
First Name
Last Name
Phone Number
*
Email
*
example@example.com
Business Information
Business Name
*
Tax Identification #
*
Primary Business Location
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Estimated Annual Revenue
*
$0-5 Million
$5-30 Million
$30+ Million
Month Business was established
*
Year business was established
*
Select your industry
*
Accommodation and Food Services
Administrative and Support and Waste Management and Remediation Services
Agriculture, Forestry, Fishing and Hunting
Arts, Entertainment, and Recreation
Construction
Educational Services
Finance and Insurance
Health Care and Social Assistance
Information
Management of Companies and Enterprises
Manufacturing
Mining
Other Services (except Public Administration)
Professional, Scientific, and Technical Services
Public Administration
Real Estate Rental and Leasing
Retail Trade
Transportation and Warehousing
Utilities
Wholesale Trade
Relationship Information
Are you an existing Dow Credit Union member?
*
Yes
No
If you work with a member representative, enter their name below.
First Name
Last Name
Submit the Paycheck Protection Program Borrower Application Form here:
*
Browse Files
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Upload most recently completed Business Taxes
*
Browse Files
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Compensation (e.g., Salaries,Wages, Commissions, and CashTips (Total from 2019*)
For employees making over$100,000 annually, please subtract the amount over$100,000 for each employee and add that amount here. (Total from 2019*)
Vacation, Parental, Family,Medical or Sick Leave (Total from 2019* )
Group Health Insurance (Total from 2019*)
Retirement Plan Funding Paid by Employer (e.g., 401(k)match) (Total from 2019*)
State/Local Taxes on Employee Compensation (i.e., EmployerUC Tax) (Total from 2019*)
Self-Employment Income (andSub-Contractors) not to exceed$100,000 per year per selfemployed persons (Total from 2019*)
Potential Maximum Loan Amount
In order to submit your Application to the Small Business Administration, we must identify the names of individuals who have an aggregate ownership of 90% or more. Please list the Applicant’s owners and the irrespective ownership percentage.
Owner Name
Title
Percent of Ownership
TIN (EIN/SSN)
Address
1
2
3
4
5
6
7
8
9
10
Submit
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