MicroEnterprise Grant Application

Contact Information

Company name*

First name*

Last name*

Street address*

City*

State/Region*

Postal code*

Business owner email address*

Business phone number*

Business Owner mobile phone number*

Website or Facebook URL*

N/A if not applicable

Business Information

Business opening date*

Month/Day/Year

How long has owner or business contact been in this type of business?*

Number of full time employees*

Number of part time employees*

Average wage of all employees*

Include average $/hour or annual salary

Project Information

Tell us about your project*

Will this project or equipment purchase increase the number of jobs? If so, how many?

Estimated total cost of project or equipment to be purchased*

Will this project or equipment purchase increase sales? *

If this project will increase sales, provide the sales projection for the next two years.

*Submitting this form will begin the process of applying for the MicroEnterprise Grant. Note you will be required to submit the following documents as you proceed through the application process:

Last 12 months profit and loss statement
Current balance sheet
Oklahoma Tax Commission Report (Sales Tax Paid Receipt)
IRS Form W9, signed and dated
Most recent annual tax return, per the Federal guidelines of the MicroEnterprise grant