GRABB Relief and Resilience Grant Form GRABB Relief & Resilience Fund– Grant Confirmation Form. Please fill out all required fields. Owner Name* First Last Email* Business Legal Name* Business Tax ID Number (EIN)* Bank Name* Bank Account*BusinessPersonal Bank Account Type*CheckingSaving Bank Account Number* The Grant Recipient affirms: 1. Grant Recipient is a business that is Black-owned (51% owned), Black-controlled and Black-led. 2. Grant Recipient has been is business before January 1 2020 3. Grant Recipient business is registered in the state of Michigan 4. Grant Recipient business has a registered address within Greater Grand Rapids Area 5. Grant Recipient business has no more than 10 FTE employees 6. Grant Recipient business has revenues of $1,000,000 or less 7. Your grant will be treated as taxable income, you will receive a Form 1099 for tax year 2020 8. GRABB will share each Grant Recipient on their social media outlets. 9. Grant Recipient authorizes the release of Grant Recipient’s name for public purposes, marketing and promotions. 10. Grant Recipient responses set forth in its Application for GRABB Relief and Resilience Fund grant are true and correct. Grant Award Amount is $2,500 Confirm and Authorize I agree This signature must match the “Name of Applying Business Owner” provided in the first section of this application. You are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. The person signing below certifies it has authority to sign on behalf of the Grant Recipient: Signature
