The McAllen Small Business Growth Fund Applicant InformationApplicant Name First Last PhoneEmail Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code SSN Texas Driver License Number Percentage ownership over the company Business InformationBusiness Name Date Established MM slash DD slash YYYY Ownership Type* Sole Proprietor General Partnership S-Corporation C-Corporation Limited Liability Company Limited Liability Partnership Employer Identification Number (EIN); (SSN if Sole Proprietor) Texas Secretary of State File Number Physical Business Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Mailing Business Address (if different from physical address) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code How many owners does the company have? Additional Owners (if applicable)If the company has more owners, please include the following from each one of the additional owners: First and Last Name, SSN/ITIN, Texas Driver License Number, Percentage ownership over the company, Phone, Email, AddressFunding requestWhat level of funding is the applicant requesting? Level I Funding Level II Funding How much money is the applicant requesting and what goals/metrics will be accomplished with it?Document SubmissionPlease upload the following documents: Drop files here or Select files Max. file size: 50 MB. 1. 5-page executive summary and appendix with images 2.Texas Secretary of State Texas File number; If the business is a Partnership please upload IRS Form 1065; If the business is an S-Corporation please upload IRS Form 1120-S; If the business is a C-Corporation please upload IRS Form 1120; If the business is a Sole Proprietor or single-member LLC please upload IRS Form 1040 Schedule C. Tax returns must be from 2020 or 2021 Audit and Claw-Back Provisions* By accepting the McAllen Small Business Growth Fund, I agree to allow the possible audit and/or review by the City of McAllen of the use and distribution of the funds from the grant for the benefit of my business. In addition, I also agree that if the money allocated is misused, i.e., used or distributed for purposes other than for what is qualified under the McAllen Small Business Growth Fund, I will be required to pay back the money granted and misused.Consent* I hereby certify that the above statements are true and correct to the best of my knowledge. I understand that a false statement may disqualify me for benefits. I attest that all of the information on this application is true. I authorize the City of McAllen and the McAllen Chamber of Commerce to investigate and verify the above information and contact any references regarding this application. I also authorize to perform a criminal background check, as authorized by law. The release of all information by the City of McAllen and the McAllen Chamber of Commerce in any manner is hereby authorized whether such information is of record or not and I hereby release all persons, agencies, firms, companies, etc., from any damages resulting from such information. I understand that the City of McAllen and the McAllen Chamber of Commerce will make a final decision whether the grant is approved or denied and that I can’t appeal the final decision if the benefits are denied. I agree to be audited for the use of grant funds received. Δ
