HomeMy WebLinkAboutCRITE_APP_W9.pdfSMALL BUSINESS ASSISTANCE GRANT APPLICATION
Complete the fillable application in its entirety. Print the completed application, sign and date and email, along with a copy of your W-9, to: OED2@auburnwa.gov.
Applications can also be mailed to the following: City of Auburn Attn: Office of Economic Development 25 W Main Auburn, WA 98001
TO BE COMPLETED BY APPLICANT
Name of Business: C ::f' ,\-e_'-C' �a'l'\. � \ J �'£"\.C....
· · ":yo� -:S-e:� So�L ������I..)..� e.'(\ Na me of Business Owner(s): \...o,.,.r ,t � �q_ ...::l.. '°" "'"', \�\ i;C' ,.r-�\c_\:_
Business Address: 37,t;;l lu,,) \,.) J,,...\....e_
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City of Auburn Business License number: �)....S 26559
Expiration Date of Business License: ________ _
Contact Person Name and Title: , �.� X: ¼0,..,\. �,����,c_�
Contact Person E-mail: \l,�\. .&--r:e�e..::t, �@ c_-t, \..e._�'\o\l\..'1'--�-coM_
Contact Person Phone: c�3) °t 2,C,-B �'-\:E
(Optional) Is this business 51% minority-owned or women-owned (Y@:)_
Please initial each to confirm:
�10 or fewer employees
� A for profit business in the City of Auburn established prior to January 1, 2020
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X
8/18/2020
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