Grant Intake Information
Fill out this short form for us to start the process of onboarding you as a client. By signing this form, this signals to us that you are ready to begin the process. Do not fill out this form if you are still deciding if you would like for us to render this service for you.
Business Owner
*
First Name
Last Name
Business Name
*
Contact Number
*
E-mail
*
example@example.com
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Which program are you wanting to apply for? (SELECT ALL THAT APPLY)
*
PPP
EIDL
EIDL Advance
SVO Grant
Do you have employees? Employees are w2 workers not 1099.
*
Just Myself
1-20
20-50
50-75
75-150
150-500
500 and up
Do you have a bank account either personal or business bank account with some banking history ?
*
YES
NO
Was your business in operation by Feb 1, 2020?
*
Yes
No
Business Structure
*
Sole Prop
Single Member LLC
Multi Member LLC
S-Corp
C-Corp
Non- Profit
Partnership
Did you get a PPP or EIDL advance/loan on this business already?
Yes
No
EIN
if you dont have a EIN us your SSN
Voided Check or Direct Deposit Form (from Bank) *
Type of Bank
*
Personal Checking
Personal Savings
Business Checking
Business Savings
Personal Trust
Business Trust
Non-Profit Trust
Escrow
Routing
*
Account
*
Please upload a picture of the front of your ID and an upload of the back of your ID
Please Upload Feb 2020 Bank Statements
Please Upload 2019 and or 2020 Business Tax Return
Please Upload (signed and dated) forms 940, 941's or 944 for 2019 & 2020
Submit Registration
Should be Empty: