Grant Application Part 1

Information provided during the application process is the responsibility of each applicant. Applicants will not hold The Foundation, its affiliates, members, partners, and staff liable for any losses, damages, costs, or expenses, of any kind relating to the use or the adequacy, accuracy, or completeness of any information loaded in the form. Each question should be read carefully, and answers accurately answered. Thank you for submitting your application!

Note: Only one business per owner/applicant is eligible. Applicant must be a majority owner with the authority to sign on behalf of the organization. Please complete ALL THREE SECTIONS to be considered for a Grant.

Section 1: Personal / Business Information

First Name *

Middle Name

Last Name *

Current Mailing Street Address *

Current Mailing Address City *

Current Mailing Address State *

Current Mailing Address Postal Code *

Phone *

Email *

Percentage Owned *

OR Are you a non-owner completing this application on behalf of the business?

Legal Business Name *

Business DBA (if different than legal name)

Corporation Street Address

Corporation Address City

Corporation Address State

Corporation Address Postal Code

Business Street Address *

Business City *

Business State *

Business Postal Code *

Business Mailing Address

Business Mailing City

Business Mailing State

Business Mailing Postal Code

Organizational Structure *

Organizational Structure is Other

Section 2: Grant Eligibility Information

Email *

First Name *

Last Name *

Legal Business Name *

Area where business is located *

Specify Other for Area Where Located

Select the Operating Status that best matches your current situation *

Expected Date to Reopen

How many Full-Time Equivalent (FTE) employees did your business have as of Sept. 27, 2024? *

How many Full-Time Equivanent (FTE) employees do you currently have? *

Section 3: Business Owner Certification

The Foundation for Lake Lure/Chimney Rock Area Businesses relies on these certifications provided by the Business Owner (Applicant). These certifications cover the utilization of funds, business eligibility, owner details, and financial information related to both the business and its owner. The details are being or will be submitted as part of the grant application process and/or the final grant agreement documentation. Applicants are required to make these certifications in good faith, acknowledging their legal responsibility to provide accurate and truthful information. A designated and authorized representative of the Applicant must certify such compliance.

Please review the following statements. Select "Yes" to certify your acceptance. Select"No" to certify that you do not accept.

(WARNING a no response to any of the following statements will make this preliminary application ineligible for a grant award)

Email *

First Name *

Last Name *

Legal Business Name *

My business has been in operation since Sept. 27th, 2024 or earlier?

My business has a physical location within the eligible region, as defined in the Eligibility Criteria for this grant program.

I understand that if I receive an award, my business name, award amount, and number of jobs supported may be publicly announced, and I agree to this disclosure. All other information will be kept strictly confidential.

I understand and agree that funds may only be used for operating costs, including hiring and payroll costs, and expenses incurred in reopening or otherwise resuming normal operations of my business.

By certifying "Yes" to this statement, I authorize Foundation for Lake Lure/Chimney Rock Area Businesses to request and review the Applicant’s state and federal tax returns as well as tax return information. I hereby warrant that I am an authorized representative of the Applicant and have full authority to waive confidentiality under state and federal law and authorize release of this information.

I certify that the information provided in the grant application submitted for this program and, if selected for a grant award, the information provided in all supporting documents and forms is true and accurate in all material respects. I understand that knowingly making a false statement to obtain a grant is punishable under state and federal law.

As an Applicant, I understand that any grant funds received through the Program are considered taxable revenue. As such, the Program Administrator will issue a 1099 Form to all businesses required to receive them.

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PO Box 113, Lake Lure NC 28746

(919) 522-7980

[email protected]

Email us at [email protected]

The Foundation for Lake Lure Chimney Rock Area Business is a nonprofit, tax-exempt charitable organization (EIN 33-1752743) under Section 501(c)(3) of the IRS Code. Donations are tax-deductible as allowed by law.

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Grant Application Part 1

Section 1: Personal / Business Information

Section 2: Grant Eligibility Information

Section 3: Business Owner Certification

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Email us at [email protected]

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