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COVID-19 Small Business Resiliency Loan Application

  1. COVID-19 SMALL BUSINESS RESILIENCY LOAN APPLICATION

    All submitted information is confidential, and will be used solely for the purpose of this application and its review. You will be contacted if additional information is required. Please contact the Community & Economic Development Office ( cedo@clintonma.gov ) for more information.

  2. Requests should be based on fixed costs, verifiable business losses, and additional expenses related to COVID-19, for the period beginning March 10, 2020, and ending September 30, 2020. Please provide your best estimate of projected financial impacts. Additional information may be requested.

  3. BUSINESS OWNER/ CONTACT INFORMATION

  4. Business Type/ Organization*

    Joint ownership organizations may be required to provide additional information

  5. BUSINESS LOCATION/ BUSINESS FIXED COST INFORMATION

  6. Clinton, MA 01510

  7. Do you have a commercial lease or mortgage for this address?*

    Additional information may be requested.

  8. e.g. insurances, debt maintenance, licenses, other fixed costs

  9. Does the business carry Business Interruption Insurance?*

  10. BUSINESS EMPLOYMENT INFORMATION

  11. In addition to the owner, does the business have employees for whom it withholds payroll taxes?*

  12. as of March 1, 2020

  13. Has the business/ will the business reduce full-time positions by April 30, 2020?*

  14. as of March 1, 2020

  15. Has the business/will the business reduce part-time positions by April 30, 2020?*

  16. Will Resiliency funding help retain employee positions or benefits until April 30, 2020?*

    Please provide best estimate

  17. COVID_19-RELATED EXPENSES

  18. e.g. increased cleaning/ disinfecting, compliance costs

  19. ADDITIONAL DOCUMENTATION

    Please download and complete the following documents. Responses may be uploaded to application or emaied as attachments to cedo@clintonma.gov. Please include your business name in the subject line of email correspondence. Documentation can also be mailed to the Community & Economic Development Office, Clinton Town Hall, 242 Church Street.

  20. If business is new, most recent year personal income tax return may be substituted

  21. Statements may include P & L statements, balance sheet, or other normal statements. Please contact CEDO if assistance is needed

  22. Please describe the steps that you are taking during this crisis to ensure the long-term viability of your business

  23. Briefly describe why your business is important to the residents of Clinton. Responses may touch upon employment, unique services or products, facilities, public benefit or community involvement, and/or years of operation in Clinton.

  24. Do you intend to apply for SBA CARES Act Assistance, or any other emergency funding?*

  25. Do you wish to receive information about additional COVID_19-related assistance opportunities?

  26. CERTIFICATIONS AND SIGNATURE

  27. By checking each of the following boxes, I certify that:*

  28. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  29. Please enter today's date

  30. Leave This Blank:

  31. This field is not part of the form submission.