Fort Bend County Small Business Emergency Assistance Grant Program | County Judge Office

Eligibility

Check all that apply

Business currently resides within Fort Bend County?

Business is registered in the State of Texas?

Do you have at least one (1) full-time equivalent employee and no more than 50 employees?

Was the businesses 2019 annual gross revenue at least $25,000 and no more than $5,000,000?

Are you in good-standing with the State of Texas, Fort Bend County and the local government?

Contact Information

Authorized Signer/Approver

Title

Full Name

Confirm Email*

Phone

Ext.

Contact Address

Street

City

State

Zip

Federal EIN or State Tax ID Number

DUNS Number (If available)

Date Business Established

Eligible Grant Awards based on Gross Revenue:
$25,000 to $100,000 — Grant up to $5,000
$100,001 to $2,000,000 — Grant up to $15,000
$2,000,001 to $5,000,000 — Grant up to $25,000

Request Grant Amount based on gross revenue eligibility

Is the business currently in good standing with the State of Texas?

Yes

Is the business currently operational?

Yes

Was the business not operational after March 19th due to the COVID-19 Governor’s Executive Order prohibiting large gatherings and non-essential services?

Yes

Is your business recognized as any of the following (check all that apply) :

Small Business

Minority Owned

Woman Owned

Veteran Owned

Disabled Owned

Finance

Total annual revenue in 2019

Total monthly revenue in 2019

March 31^st

April 30^th

May 31^st

Total monthly revenue in 2020

March 31^st

April 30^th

May 31^st

If business was not operational before March 2019, or in the calendar year of 2019, please provide the revenue for the most recent 3 months prior to March 2020.

Month 1

Month 2

Month 3

Employee Count

Number of Employees as of March 1, 2020

Part time W2

1099s

Number of Employees as of June 1, 2020

Part time W2

1099s

Did you apply for any of the CARES ACT SBA Assistance Programs? (i.e. PPP, EIDL, EIDG or other loan program)

Yes

If Yes, did you receive these funds or is your application still pending a decision on these funds?

Yes

Did you apply for any other government assistance through any federal, state and local agencies?

Yes

If you've received PPP, EIDL, EIDG or any other assistance, you are still eligible for this grant program.

Please identify the primary anticipated use for funds from Fort Bend County: (Select only those that apply)

Personal Protective Equipment (PPE)

Working Capital

Utilities

Remote working expenses

Lease/Mortgage assistance

Marketing and Advertising for customer retention

Re-opening supplies, equipment & renovations for social distancing requirements

Payroll for employees brought back to work

Other Background Information

Has Business or its Owner(s) been debarred or suspended?

Yes

Has Business or its Owner(s) been denied a license or permit to operate the business or a license or permit suspended or revoked by any government?

Yes

Is the applicant or Owner currently indicted for or otherwise criminally or civilly charged by a government with the commission of violation of the law?

Yes

Fort Bend County has the authority to ask for any additional or clarifying information from the “applicant” for any information given or provided. If the applicant becomes aware of any information or any changes that are materially different, alter or changes the information than what was presented or provided, the applicant shall have a duty to immediately report such facts to the County in writing.

Document Upload

Please upload the following:

State of Texas Franchise Account Tax Status, dated in June, 2020
- This can be obtained through the Texas Comptroller's office.
- Use the following link to obtain the form needed for your grant application.
Rent/Lease Agreements or Mortgage Statement (if using for these funds)
Last 2 or most recent payroll statement for all employees
Brief statement of what you will specifically use these grant funds
Any information that will be helpful to the reviewer for approval of your application
Copy of a valid Driver’s License or state issued photo ID card

Attachment restrictions:

Only JPG, JPEG, PNG, GIF, PDF, DOC
A maximum of 10 files may be uploaded
Total file size must not exceed 7 MB

Choose file...

Certification of Application

I understand that if such information is willfully false, I am subject to criminal prosecution and civil action under federal law, the laws of Fort Bend County and the State of Texas.

I fully understand that it is a Federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements when applying for this grant, as applicable under the provisions of Title 18, United States Code, Section 1014.

I certify that the business has been negatively impacted by the COVID-19 declared state of emergency (e.g. has been temporarily shut down, has been required to reduce hours, has had at least a 25% drop in revenue, has been materially impacted by employees that cannot work due to the outbreak, or has a supply chain that has materially been disrupted).

I certify that the business has a material financial need that cannot be overcome without the grant of emergency relief funds at this time (e.g. does not have sufficient cash reserves that can support the business during this period of economic disruption).

I certify that to the best of my ability, the business will remain operational in Fort Bend County for at least one year, or through December 30, 2020.

I have applied for a Small Business Emergency Assistance Grant. As part of the application process, Fort Bend County and the guaranty insurer (if any), may verify information contained in my grant application and in other documents required in connection with the grant, either before the grant is awarded or as part of its quality control program.

I authorize that an electronic signature of this Application or Approval letter or Grant Agreement shall be binding on the parties.

Electronic Signature

Pursuant to written policies, Fort Bend County allows documents to be signed electronically and hereby agrees to be bound by such electronic signature. Please confirm that you, as a signatory on this document also agree to be bound by electronic signature.

I, _______________, agree to be bound by electronic signature.

I, _______________, am an authorized signer for _______________, and I accept the above terms and conditions.

Please type your full name to electronically submit this form.

Fort Bend County

Small Business Emergency Assistance Grant Program

Thank you for applying!