Navajo Small Business Relief Application

If you received a previous Grant Award you are NOT eligible to apply for this 2024 FUNDING

Navajo Nation

Welcome to the Navajo Small Business Grant Application

A Navajo Nation Program

Please use a Chrome browser to complete this application.

To be eligible for a potential relief grant, this application must be submitted on this website no later than 11:59 PM on August 31, 2024, or until total funding provided for the program is exhausted, whichever comes first.

All items must be completed

Please click the New Intake button to start the application process, or press the Upload Documents button to add documents to an existing application.

The online application must be completed and submitted.

* - Required field

* Previous Application ID:

* Last Name:

Applicant Info

* First Name:

Middle Name:

* Last Name:

SSN:

EIN:

Mailing Address:

City:

State:

Zip:

Census Number:

Chapter Affiliation:

Agency Affiliation:

Date of Birth:

Phone Number:

Email:

* Business Name:

Do you have a Business Registration Number?

Yes No

If No, do you need help with Business registration?

Yes No

Eligibility

Did your business experience financial hardship due to the COVID-19 Public Health Emergency between March 1, 2020 and April 10, 2023?

Yes No

Please Provide a description of the financial hardship you faced due to the COVID-19 pandemic:

Did you receive funding from the previous Navajo Business Economic Relief Grant Program?

Yes No

Was your business previously reimbursed by another Federal program and/or any disaster relief programs under the CARES Act (such as the Paycheck Protection Program?)

SBA Economic Injury Disaster Loan Program (EIDL)?

Yes No

If yes, what amount?:

SBA Paycheck Protection Loan Program (PPP)?

Yes No

If yes, what amount?:

In any single 12-month period prior to April 10, 2023, was your annual revenue less than $3,000,000?

Yes No

Is your Business organized as a "For Profit" business?

Yes No

Is your Business at least 51% owned by an enrolled member of the Navajo Nation?

Yes No

Was your business in operation prior to January 1, 2020?

Yes No

If yes, when was your business established? (MM/YY):

Is your business independently owned and operated?

Yes No

What are the total number of employees with your business through April 10, 2023?

List number of Employees:

Are you an enrolled member of the Navajo Nation?

Yes No

Are you 18 years or older?

Yes No

Please provide your Navajo Nation Business Registration Number/Navajo Business Regulatory Certification Number or attah your Certificate of Good Standing under the Corporations Code (If you do not have a Certification Number, visit www.navajoeconomy.org to obtain one).:

Business Registration Number:

Business Regulatory Certification Number:

To your knowledge, are you presently suspended, debarred, proposed for debarment, declared ineligible, voluntarily exluded from participation in this program by any Federal department or agency, or presently involved in any bankruptcy?

Yes No

If yes, please provide explaination:

Do you have any delinquent debts to the Navajo Nation for taxes, non-rental related debts, rental related debts, and/or loan obligations predating March 2020?

Yes No

If yes, please provide explaination:

Will you be requesting $50,000 or more?

Yes No

If yes, please provide a Unique Entity ID:

Expenditures

Gross Revenue (Sales):

Cost of Goods Sold (COGS) & Operating Expenses (must provide supporting documents such as receipts, bank statements, pay logs):

Supplies/Materials:

Advertising:

Mileage (.56 per mile):

Fees:

Employee Expenses (Wages):

Office Expenses:

Rent & Lease:

Repair & Maintenance:

Tax & License:

Utilities (Electricity/Water):

Total COGS & Opterating Expenses

Previous Awards:

Economic Injury Disaster Loan Program (EIDL)

Paycheck Protection Loan Program (PPP)

Total Previous Award Amount

Estimated Award Amount

Document Upload

Eligiblity Disclosure

By signing this application, you acknowledge that you understand the program terms and guidelines that you understand these requirements, and agree to abide by the following terms:

* 1. Consent to share Information a. I have requested assistance ("Grant") under the Navajo Business Economic Relief Fund or the Navajo Artist Relief Fund, each referred to as "Program," as applicable. I authorize representatives from the Navajo Nation to supply and receive information I provide related to this Program. I understand and consent to the disclosure of public and non-public person information by and between the issueing agency of the Navajo Nation in connection with this grant Program, including, but not limited to: data and documentation verification, review, Program and assistance evaluation, and monitoring and oversight.

* 2. All information provided is truthful and accurate a. I certify that the information and statements I have prodived herein are truthful and accurate. I understand that the information and documentation I submit will be provided to the Navajo Nation government and its auditors, might be subject to further review and audit by the U.S. Department of Treasury Office of the Inspector General, and that my participation in this assistance Program is subject to the legal restrictions of the federal CARES Act and corresponding U.S. Treasury guidance, Navajo Nation and federal laws, and the requirements of the Navajo Business Economic Relief Fund or the Navajo Artist Relief Fund, as applicable. I agree to comply with the guidlines of the Program as determined and presented by the Navajo Nation. Failure to provide truthful and accurate information may cause this application to be rejected, or for the Navajo Nation to compel me to repay the awared funds to the Nation.

* 3. Certification of eligibility and authorization to submit application a. I certify that I, or my business entity, meet the eligibility requirements to apply for assistance under the Navajo Business Economic Relief Fund or the Navajo Artist Relief Fund, as applicable, and that if the applicant is a business entity I am legally authorized to submit this application on behalf of and to legally bind the applicant entity

* 4. No "double dipping" a. I certify that the amount requested has not been previously reimburesed by another Federal program, any disaster relief programs under the CARES Act (such as the Paycheck Protection Program) or any other Navajo assistance program.

* 5. Required Reporting a. Applicant will be required to submit a final report providing a final accounting of the uses of funds which should be supported by documentation such as receipts, invoices, etc. This must be submitted within 90 days after the end of the grant period or December 31, 2024, whichever comes first. Applicants that do not submit a final report will be out of the compliance with this grant program and will be asked to return the funding.

* 6. IRS Form W-9 a. All applicants must submit a complete and signed IRS W-9 form. A W-9 form is an Internal Revenue Service (IRS) tax form that is used to confirm a person's name, address, and taxpayer identification number (TIN) for employment or other income-generating purposes. When an individual or business entity receives $600 or more during a tax year, that income must be reported to the IRS. Approved applicants will receive an IRS Form 1099 upon tax season.

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Signature Certification

By entering my name in the box below I certify that all information is correct and accurate to the best of my knowledge.

* Signature: