Job Creation Assistance Program Application and Checklist
Panama City Community Redevelopment 501 Harrison Ave Room #206 Panama City, FL. 32401 (850) 872-7230
Job Creation Assistance Program Guidelines
SECTION 1. APPLICANT/BUSINESS OWNER
Applicant Name
*
First Name
Last Name
Applicant Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Applicant Phone Number
*
Applicants phone number
Applicant Email
*
example@example.com
SECTION 2. BUSINESS INFORMATION
Business Name
*
Please provide the businesses legal name
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Phone Number
*
Please enter a valid phone number
Business Website
Please provide business website if applicable
Type of Business
Please provide what type of business this is
SECTION 3. CONFLICTS OF INTEREST
Conflicts of Interest
Please list any conflicts of interest
By signing below, I affirm I have read and understand the Rules & Guidelines for the CRA Job Creation Program and agree to the terms therein. I understand I am required to submit all supporting documentation found in the CRA Job Creation Program Checklist; applications missing documentation are considered incomplete and will not be accepted or considered. CRA’s acceptance of complete application is for review and consideration, and in no way is a guarantee of approval for the CRA Job Creation Program Grant offered by the City of Panama City, Community Redevelopment Agency (CRA).
*
Applicant Printed Name
*
Date
*
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Month
-
Day
Year
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SECTION 4. JOB CREATION ASSISTANCE PROGRAM CHECKLIST
1. Business Opening Date
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Month
-
Day
Year
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2. Business is:
*
a new business
an existing business relocating
an existing business expanding
3. Copy of lease (if applicable)
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Please upload a copy of the lease if applicable
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4. Copy of Applicants Drivers License
*
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Please provide a copy of applicants drivers license
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5. Proof of Business Ownership
*
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Please provide proof of business ownership
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6. Copy of Business License
*
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Please provide a copy of the city issued business license
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7. Description of the Business
*
A description of the business to include type of business, hours of operation
8. List of Jobs Created
*
A list of jobs created including job descriptions, pay range and weekly schedule
9. List of Current Employees
*
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A full list of all current employees including job descriptions, pay range, and position status (part-time, full-time, or seasonal)
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10. W-9 Completed and Signed (required to receive funds)
*
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