HomeMy WebLinkAboutSSAUTO.pdf/:/s-c� SMALL BUSINESS ASSISTANCE GRANT APPLICATION 4116 lv�D '11-4 YQ�, ,2 '? lO;o lication� O:::�Complete the fillable application Print the completed appsign and date and email, along with in a its copy entirety. of your W-9, to: OED2@auburnwa.gov. IC '£:
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: s & s B rs T A l/[o s Aif s
Name of Business Owner(s): Sam �am mao-1
Business Address: 211 z M'!t)\A.iv\ Wo1. 1 ,111,, �y b{4 m W/.l ? t'CJ o2.
City of Auburn Business License number:_
Expiration Date of Business License: 02-2-1-JaZI
Contact Person Name and Title: 3 Q}Y\ \\ q,.r>1 trl�/lc,1,.,J(let1
Contact Person E-mail: SAm SS8bSTAl-l'To.StllGS §2��} � CoWl
Contact Person Phone: � 253 oSZ. 22✓4-¼
(Optional) Is this business 51% minority-owned or women-owned (Y /N) __ _
Please initial each to confirm:
_L_ 10 or fewer employees
_L A for profit business in the City of Auburn established prior to January 1, 2020
1
BUS-29751
DocuSign Envelope ID: 8BC012F3-718E-4A38-92E4-2A6261C6FF7B
DocuSign Envelope ID: 8BC012F3-718E-4A38-92E4-2A6261C6FF7B
DocuSign Envelope ID: 8BC012F3-718E-4A38-92E4-2A6261C6FF7B
8/31/2020
X
DocuSign Envelope ID: 8BC012F3-718E-4A38-92E4-2A6261C6FF7B