Small Business Relief Fund by the Community Foundation of West Alabama
in cooperation with The Chamber of Commerce of West Alabama

Businesses applying for the Small Business Relief Fund must meet all of the following criteria:

- Must have experienced a financial hardship as a result of COVID-19

- Must have employed less than 50 (FTE) employees as of February 29, 2020

- Must be in good standing with federal, state, and local government jurisdictions

- Must be located in one of the following counties in West Alabama: Bibb, Fayette, Greene, Hale, Lamar, Marengo, Pickens, Sumter, or Tuscaloosa. (*** NOTE: To be eligible for the funding made available from the City of Tuscaloosa’s Restart Tuscaloosa initiative, a business must meet all of the above mentioned criteria AND the following criteria as well: 1) Hold the appropriate business license(s) from the City of Tuscaloosa, 2) Be in good standing with the City of Tuscaloosa, and 3) Be physically located in one of the seven (7) council districts within the city limits of Tuscaloosa.***)

****** NOTE: In May 2020, the City of Tuscaloosa invested $1 million of Elevate Tuscaloosa money into the fund. As of August 18, 2020, all of the $1 million has been granted to businesses in Tuscaloosa.******

- All businesses MUST complete and submit a W-9 form as part of the application process. The form can be completed online at https://www.irs.gov/pub/irs-pdf/fw9.pdf. Email the completed W-9 form to Projects@TuscaloosaChamber.com. Applications received without a properly completed W-9 (including signature) WILL NOT be considered for funding.

CERTIFICATION

By submitting this application, you are (1) CERTIFYING that all information provided in this application is true and accurate; that the Applicant business entity is in good standing and authorized to conduct business under the laws of any jurisdiction(s) in which the entity is organized or operates its business; and that as of February 29, 2020, the Applicant owes no delinquent taxes to any taxing entity or authority, including the City of Tuscaloosa, unless otherwise disclosed in this application; (2) GRANTING us permission to contact your primary bank, mortgagor or landlord (as applicable), any owner of the Applicant or otherwise verify information included in your application if determined helpful in assessing your application; and (3) AGREEING to cooperate and assist in the verification of information provided in this application and to provide additional information if requested. Applicant further understands that should the Applicant herein be awarded assistance and there is a subsequent determination that misleading or false information was provided in this application or otherwise provided to obtain the assistance, the Applicant may be subject to civil or criminal penalties.
Email *
ORGANIZATION TYPE *
ORGANIZATION'S LEGAL NAME *
TRADE NAME(S) (if different from legal name)
PROVIDE THE NAME(S), POSITION(S), PHONE NUMBER(S), AND EMAIL(S) OF THE INDIVIDUAL(S) TO CONTACT FOR INFORMATION NECESSARY TO PROCESS THE APPLICATION *
DATE OF ORGANIZATION FORMATION *
This is the date of legal formation.
MM
/
DD
/
YYYY
DATE BUSINESS ESTABLISHED (if different from Date of Organization Formation)
This is the date the business actually began operation.
MM
/
DD
/
YYYY
STATE OF ORGANIZATION FORMATION *
CURRENT MANAGEMENT SINCE (date current Applicant(s) purchased business, if different from above)
MM
/
DD
/
YYYY
FEDERAL E.I.N. *
BUSINESS PHONE NUMBER (including area code) *
BUSINESS MAILING ADDRESS *
This must include mailing address, city, state, and zip code. If the business receives funding from this program, we will use this address to mail a physical check. We will not use direct deposit.
PHYSICAL BUSINESS ADDRESS(ES) *
This must include the physical address, city, state, and zip code.
BUSINESS REAL PROPERTY IS *
IF REAL PROPERTY IS LEASED, PROVIDE THE NAME, PHONE, AND EMAIL OF THE LESSOR
HAS THE ORGANIZATION, BUSINESS, OR ANY LISTED OWNER REQUESTED A DEFERMENT OF ANY LEASE PAYMENTS ON REAL AND / OR PERSONAL PROPERTY? If "Yes," was such a deferment granted? Provide details including the length of the deferment. *
BUSINESS ACTIVIT(IES) / TYPE OF BUSINESS(ES) *
EXCLUDING ORGANIZATION OWNER(S), LIST THE TOTAL NUMBER OF EMPLOYEES (as of February 29, 2020) *
Specify the number of full-time employees, number of part-time employees, and the average weekly hours for part-time employees.
HOW HAS COVID-19 IMPACTED YOUR BUSINESS? *
Please provide details about how the virus has impacted your business. Items that you might want to include are business closure, lost revenue, laying off employees, etc. Be as specific as possible.
DETAIL THE SPECIFIC LOSSES THAT YOUR BUSINESS HAS INCURRED DUE TO COVID-19. *
NAME OF PRIMARY BANK, CREDIT UNION, OR OTHER FINANCIAL INSTITUTION. YOUR PRIMARY POINT OF CONTACT (INCLUDE PHONE AND EMAIL OF YOUR CONTACT) AT YOUR FINANCIAL INSTITUTION.
HAS THE ORGANIZATION, BUSINESS, OR ANY LISTED OWNER REQUESTED A DEFERMENT OF ANY LOAN AND / OR MORTGAGE PAYMENTS? If "Yes," was such a deferment granted? Provide details including the length of the deferment. *
ORGANIZATION OWNER(S) - List the following for each owner specified below - Legal Name, Title / Office, % Ownership of Company, SSN/EIN, Complete Mailing Address, Phone Number, and Email Address. *
"Owner" is defined as: 1) Proprietor, 2) Limited Partner who owns 20% or more interest and each General Partner, 3) Stockholder or Entity owning 20% or more non-voting or voting stock, or 4) limited liability company member owning 20% or more non-voting or voting membership.
DOES THE ORGANIZATION, BUSINESS, OR A LISTED OWNER HAVE ANY OUTSTANDING JUDGMENTS, TAX LIENS, PENDING OR THREATENED BANKRUPTCY PROCEEDINGS, PENDING OR THREATENED LAWSUITS AGAINST THEM, OR CRIMINAL PROCEEDINGS? If "Yes," please explain. *
IS THE ORGANIZATION, BUSINESS, OR A LISTED OWNER DELINQUENT ON ANY FEDERAL, STATE, OR LOCAL TAXES OR ASSESSMENTS; DIRECT OR GUARANTEED LOANS; LEASES; CONTRACTS; GRANTS; CHILD SUPPORT PAYMENTS; OR ANY OTHER OBLIGATIONS? If "Yes," please explain. *
DOES ANY OWNER, OWNER'S SPOUSE, OR HOUSEHOLD MEMBER WORK FOR OR SERVE IN AN OFFICIAL CAPACITY FOR LOCAL OR STATE GOVERNMENT, COMMUNITY FOUNDATION, CHAMBER OF COMMERCE, OR ANY OTHER ENTITY ASSOCIATED WITH THIS PROGRAM? If "Yes," please explain. *
PLEASE LIST MONTHLY AND ANNUAL GROSS REVENUE (prior to February 29, 2020) *
HAS THE ORGANIZATION REQUESTED FUNDING, INCLUDING GRANTS AND LOANS OF ANY KIND, FROM OTHER SOURCES SINCE MARCH 1, 2020 RELATING TO FINANCIAL HARDSHIP RESULTING FROM COVID-19? If "Yes," please list all other funding sources applied to and the corresponding amounts. *
TOTAL AMOUNT REQUESTED AS PART OF THIS APPLICATION. *
It is our hope to assist as many of our local small businesses as possible. We understand that this award amount (if granted) will not meet all of your needs. We are attempting to balance the needs of each individual business with the resources currently available in the SBRF fund. We are continuing to do fundraising efforts to increase the amount of funding available for each business. At this point in time, we are asking for each applicant to only request an amount that will bridge the gap between now and when another funding source provides assistance for your business (e.g. SBA Economic Injury Disaster Loan, Paycheck Protection Program, West Alabama Regional Commission Revolving Loan Fund, etc.). These requests should be at $20,000 or less. Please note that the average award in Rounds 1 through 6 was approximately $2,100. Future awards may be higher or lower than that amount based on available funds and the number of qualified applications received. We encourage all businesses to take advantage of all programs for which they qualify.
TOTAL AMOUNT REQUESTED FROM ALL FUNDING SOURCES. *
DESCRIBE HOW THE FUNDS REQUESTED FROM THE SMALL BUSINESS RELIEF FUND WILL BE USED. *
Please be specific, including dollar amounts and timelines. It is important to note that almost all small businesses have been impacted substantially by the COVID-19 virus. These impacts having included a significant loss of revenue. THIS FUND IS NOT INTENDED TO REPLACE LOST REVENUE. It is intended to assist companies in covering a portion of the business' expenses while they are applying for additional relief from the Small Business Administration (SBA) and elsewhere. See below for specific programs.
HOW MANY WEEKS OR MONTHS WILL THE FUNDS REQUESTED FROM THE SMALL BUSINESS RELIEF FUND SUSTAIN THE BUSINESS IF THE CURRENT CONDITIONS CONTINUE? (Please be specific and include timelines.) *
PLEASE INCLUDE ANY ADDITIONAL INFORMATION THAT YOU BELIEVE SHOULD BE CONSIDERED AS PART OF THIS APPLICATION THAT WAS NOT SPECIFICALLY ADDRESSED IN A PREVIOUS QUESTION.
ARE YOU AWARE OF THE PAYCHECK PROTECTION PROGRAM (PPP)? *
The Small Business Administration (SBA) Paycheck Protection Program (PPP) is available for small businesses. This program is designed to provide 100% federally guaranteed loans to small businesses who maintain their payroll during this emergency. These loans may be forgiven if borrowers maintain their payrolls during the crisis or restore their payrolls afterward. To access PPP funding, you must go through an approved SBA Lender. We recommend that you start with your existing banking relationship to determine if they are an approved lender for this program. If they are not, you can find an approved SBA Lender by visiting https://www.sba.gov/paycheckprotection/find.
ARE YOU AWARE OF THE U.S. SMALL BUSINESS ADMINISTRATION (SBA) - ECONOMIC INJURY DISASTER LOAN (EIDL)? *
The Economic Injury Disaster Loan (EIDL) can provide up to $2 million of financial assistance to small businesses. This is a low-interest federal disaster loan for working capital to assist small businesses suffering substantial economic injury as a result of the Coronavirus (COVID-19). Included in this program is a loan advance of up to $10,000 in funding. This loan advance will provide immediate economic relief to businesses that are experiencing a temporary loss of revenue. Funds will be made available within three days of successfully completing the EIDL application (https://covid19relief.sba.gov/). This loan advance will not have to be repaid. We have a webinar about the EIDL program on The Chamber’s COVID-19 website (https://tuscaloosachamber.com/COVID-19-resources/).
ARE YOU AWARE OF THE WEST ALABAMA REGIONAL COMMISSION SMALL BUSINESS REVOLVING LOAN FUND? *
The West Alabama Regional Commission operates a Revolving Loan Fund for the purpose of assisting small local businesses and industries in their start-up and expansion activities. During these unprecedented times, they are focusing the fund to help and support small businesses in the region impacted by COVID-19. The goal of the program is to create new jobs for citizens of West Alabama. The RLF provides gap financing that is not available from commercial lenders. The brochure and loan application can be found at The Chamber's COVID-19 Resources website (https://tuscaloosachamber.com/small-business-financial-assistance/).
DISCLAIMERS *
1. Application for the Small Business Relief Fund DOES NOT GUARANTEE award of funding. 2. The total amount awarded will be based on funds received. 3. All businesses receiving funding MUST complete a W-9 form prior to receipt of funding. 4. It is the sole responsibility of the Applicant to determine or to seek independent advice to determine the tax implications to the Applicant and its Owners associated with any Small Business Relief Fund funds received by the applicant. Please confirm your understanding of these disclaimers by clicking "Yes".
CERTIFICATION *
By typing your full name in the space below, you are certifying that all of the information provided in this application is true and accurate. You are granting us permission to contact your primary bank, landlord (if applicable), and the owners of the Applicant if determined helpful in assessing your application. You are also agreeing to assist in the verification of information provided in this application and to provide additional information, if requested.
"PAY IT FORWARD" - IF FINANCIALLY FEASIBLE, WOULD YOU BE WILLING TO "PAY FORWARD" SOME OR ALL OF ANY GRANT AWARDED TO YOU? *
Although this program is a grant program, it is our desire to make this fund self-perpetuating so we have money available for whatever future disaster our community might experience. To that end, we are encouraging each recipient to contribute financially to the Community Foundation of West Alabama's Small Business Relief Fund an amount equal to, or greater than, the amount of the awarded grant funds once your business is back on its feet, if feasible. Contributions to the Community Foundation of West Alabama are tax deductible, subject to any particular limitations on the donor. NOTE: A "YES" RESPONSE TO THIS QUESTION IS NOT A REQUIREMENT FOR RECEIPT OF A GRANT FROM THE SMALL BUSINESS RELIEF FUND.
Important:
The Small Business Relief Fund is a Community Foundation of West Alabama fund in cooperation with The Chamber of Commerce of West Alabama.
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy