Grant Application

I am applying for*

Loan

Amount Requested For Loan*

Please enter a number less than or equal to 25000.

My business is located in a “highly distressed” area:*

Yes
No

Were you a financially viable entity prior to March 7, 2020?*

Yes
No

Number of employees*

Business Type*

Have you been negatively affected by the COVID-19 state disaster emergency?*

Yes
No

Please describe how you have been negatively affected by the COVID-19 state disaster emergency:

Please describe in detail the intended use of the funds being requested and how the use of the funds enhances the ability of this business to survive. Grant proceeds must be used for the purpose of acquiring personal protective equipment or installing equipment necessary to prevent the spread of COVID-19 and will require supporting invoices.

Are the funds being requested under this program enough for your needs?*

Yes
No

Business Information

Business Name*

Federal EIN Number*

Borrowing Entity(if different from Business Name)*

Business Address*

Street Address Address Line 2 City State ZIP Code

Website Address

Date business was established:*

MM

DD

YYYY

Number of Years Operating in Yonkers*

Type of business*

Does the business have any judgements or tax liens within the past 3 years?*

Yes
No

If yes, please describe

Please describe the business you conduct in Yonkers

Prior Year Revenues (Please use your most recent tax filing)

Prior Year Revenue

Have you received funding from the United States Small Business Administration Program (e.g. Paycheck Protection Program [“PPP”] or Emergency Injury Disaster Loan [“EIDL”] or any other government program since the beginning of the state disaster emergency?*

Yes
No

If Yes, describe the amount of assistance you have received and the date it was received. Please also explain why those funds were insufficient to meet continuing operating needs

List any and all other funding you are currently seeking or have recently been awarded in response to COVID-19, including but not limited to Bank loans, SBA loans, Public or private loans, grant funding, etc.

Please describe any other sources of funding available to your business:

Applicant Contact Information

Primary Name of Contact*

First Last

Title*

Phone Number*

Email Address*

PRINCIPAL/OWNER INFORMATION

Principal/Owner Full Name*

Percentage of business owned*

Address*

City*

State*

Home Phone

Cell Phone

Email*

Date of Birth*

MM

DD

YYYY

SSN/EIN*

Total Household Income

Household Size

Is there an additional Principal/Owner?*

Yes
No

If yes, please list

Additional Information

Is the principal place of business within Yonkers?*

Yes
No

Has the COVID-19 crisis resulted in a decline of revenue for your business?*

Yes
No

Please describe

Is your plan to remain in operation or to re-open the business after any mandated closures and/or social distancing is relaxed?*

Yes
No

Is your business open now?*

Yes
No

Have you filed the last two years tax returns for your business?*

Yes
No

Do you owe sales or payroll tax to NYS?*

Yes
No

If yes, please describe

Do you own or rent the property in which you operate your business?

Own
Rent

Where is your business located?

Have you applied, and been approved, for any other grants or loans related to COVID-19 Relief?*

Yes
No

REPRESENTATIONS AND WARRANTIES

LOAN APPLICANTS ONLY

I hereby represent, warrant, and certify to the YIDA that I shall employ best efforts to ensure that the number of FTE jobs to be retained during the State disaster emergency will be:

number of FTE jobs to be retained

Insert the number of FTE jobs to be retained in box above

I hereby represent, warrant, and certify to the YIDA that I shall not receive more than $25,000 in loans collectively from Industrial Development Agencies during the state disaster emergency.

GRANT APPLICANTS ONLY

I hereby represent, warrant and certify to the YIDA that I shall use the funds received by the YIDA for the purpose of acquiring personal protective equipment or installing fixtures necessary to prevent the spread of novel coronavirus during the period in which the state disaster emergency is in effect.

I hereby represent, warrant, and certify to the YIDA that I shall not receive more than $10,000 in grants, collectively, from Industrial Development Agencies during the state disaster emergency.

BY SUBMITTING THIS APPLICATION

I/We authorize the YIDA to obtain any information relating to my/our credit worthiness from any source, including a credit reporting agency, at any time during the loan application process or while any balance is outstanding.
I/We hereby certify that the foregoing is true and complete to the best of my/our knowledge and belief.
I have submitted the required additional documentation below.
I acknowledge that the YIDA will rely on the representations made herein when acting on this application and hereby represent that the statements made herein do not contain any untrue statement of a material fact and do not omit to state a material fact necessary to make the statements contained herein not misleading.
I hereby release YIDA and the members, officers, servants, agents and employees thereof and agree that the YIDA shall not be liable for, and I agree to indemnify, defend, pay and hold the YIDA harmless from and against any and all liability arising from or expense incurred by the YIDA concerning the loan application process.
1. I certify that all information provided in this application is true and correct to the best of my knowledge. I further understand that any false statements or information provided in this application or directly to representatives of YIDA may result in the denial of this application or forfeiture of any funds awarded to the applicant, which YIDA reserves the right to recoup through legal proceedings and for which the applicant shall be responsible for costs and attorney’s fees if judgment is awarded to YIDA.
I acknowledge that YIDA has the sole and absolute discretion as well as the final decision-making authority with respect the granting or denial of all applications submitted to this program. Such decisions are final and not subject to challenge in any forum.

Please upload the following documents below

2019 business tax returns (or most recent year filed ) UPLOAD HERE for each*

2019 personal tax returns (or most recent year filed)*

Business Financial Statements as of 12/31/19*

Income and expense statements for past 12 months*

EIN verification letter*

Copy of Driver’s Licenses or State issued identifications*

Application will be deemed complete ONLY after all documentation has been provided. All approved applications will be posted on our website. You will be provided the opportunity to choose which information is redacted by a YIDA representative before any information is posted.