JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
COVID-19 Enterprise Loan Fund Preliminary Application
New Castle Henry County Economic Development Corporation (Indiana)
Sign in to Google
to save your progress.
Learn more
Logo
Name of Business
Your answer
Type of Business
Sole Propreitor
LLC
Sub S
Other
Clear selection
Main Contact (Name, Telephone, E-mail)
Your answer
Provide Names of all Business Owners
Your answer
Address of Business
Your answer
Type of Business (describe product or service and customers)
Your answer
When was the Business Established?
Your answer
Number of Employees
Your answer
Average Wage of Employees (excluding benefits)
Your answer
Describe Benefit Package Offered to Employee
Your answer
Amount Requested and Proposed Use of Funds (Maximum $12,000)
Your answer
List All Other Business Debts
Your answer
Is Business Current on All Taxes
Yes
No
Clear selection
Will Business Owner(s) sign Personal Guarantee for Loan?
Yes
No
Clear selection
Describe Collateral Offered to Secure Loan
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of New Castle Henry County Economic Development Corp..
Does this form look suspicious?
Report
Forms
Help and feedback
Help Forms improve
Report
