Business Relief Loan Program

2. 1. General Business Information
4. Registered Business Name
6. Number of Years in Business
8. Business Owner(s) Name(s)
10. Email
12. Cell Phone
14. Business Address
16. Mailing Address
18. Loan requests may be made in any amount from $5,000 - $10,000.
20. Amount of Loan Application Request ($)
22. What do you plan to use the money for?
24. 2. Application Attachments
26. A. Please provide estimated cash flow projections for your business - attach your own cash flow spreadsheet or download the template below to fill out and attach.
28. Click to Download
    Cash Flow Projection Template
30. B. Please provide 2018 Tax Return.
32. Please provide 2019 Tax Return.
34. C. Attach year-to-date Profit and Loss Statement (Income Statement).
36. D. Attach year-to-date Balance Sheet.
38. E. Please attach current bank statements from both business and personal accounts.
40. Additional File Upload
42. Additional File Upload
44. Signature (Please Type Your Name)
45. Date
    Date

    Date
47. Thank you for applying to the Mount Airy Business Relief Loan. You will receive a call from the Town Administrator regarding your application within the next few business days. Please note that loan protection is required and will be discussed with you..
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49. 1. Receive an email copy of this form.
50. Email address

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