COVID-19 Business Assistance Application

General Business Information
Please upload your official federal tax ID/EIN document. This can include a W-9, Schedule C, Form 1099.
Files must be less than 2 MB.
Allowed file types: pdf.
The North American Industry Classification System (NAICS) is the standard used by Federal statistical agencies in classifying business establishments for the purpose of collecting, analyzing, and publishing statistical data related to the U.S. business economy. For more information or business code classification, https://www.census.gov/eos/www/naics/
Do you have a City of Tualatin current business license? *
Is this business considered to be a part of a national chain? *
Economic Impact (Select all that apply)
Has your business prohibited from indoor operation as a result of the "Two-Week Pause Order?" (If yes, skip the next two questions.) *
Was your business prohibited from operating as a result of the "Stay Safe, Stay Home Executive Order 20-12?
Has your business complied with all known State of Oregon COVID-19 rules, regulations, and restrictions for your particular industry? *
Did your business experience at least a 10% decrease in revenue or net income from the period October - December 2020 versus the same period in 2019? *
This can be a simple one-page QuickBooks's export or Excel spreadsheet.
Files must be less than 2 MB.
Allowed file types: pdf.
1 Full Time Employee (FTE) = 40 hours per week Have Part Time Employees? 1 PTE 20 hours per week + 1 PTE 20 hours per week = 1 Full Time Employee
You do not need to upload the entire lease. You only need to provide the primary page indicating rent and location and signature page.
Files must be less than 2 MB.
Allowed file types: pdf.
If you business recieved any local, county, state or federal assistance since March 1, 2020, please indicate below:
Please identify all programs and amounts your business received from the federal CARES Act or other programs in relation to COVID-19 business assistance. If none, enter 0.
Business Owner Demographics, please check all that apply:
Race and Ethnicity *
Gender *
Veteran Status
Statement of Understanding & Certification
I certify to the best of my knowledge that all information contained in this portion of the application, including all attachments, is valid and accurate. That I am an authorized agent of the applicant within the authority granted by the applicant’s articles of incorporation, articles of organization or bylaws to submit this application. Failure to comply with eligible use of proceeds, or making a material misrepresentation about the business and its operations to qualify for an award will be a provision of default of the award and subject the award to recapture. The City of Tualatin reserves the right to request additional documentation from the applicant to verify the accuracy and authenticity of the information provided. Should the City determine a misrepresentation exists creating a default, the award may be forfeited and/or subject to repayment. Failure to repay or cure a default will result in any and all collection actions permissible by law, including through third party collection services or the Oregon Department of Revenue. The applicant agrees to allow the City to pursue such collection actions.
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