Infrastructure Grant Application

Qualifications:

Must have a minimum of 7 Full Time Employees pay is equal to or greater than $30,000 and offer medical benefits where the employee pays no more and 50% of premiums.

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*

What infrastructure do you need assistance with? Include timeline of project and explain financial need.

Estimated total cost of project*

*Submitting this form will begin the process of applying for the Infrastructure 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), if applicable
IRS Form W9, signed and dated