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Application for Small Business


General Instructions

Please include requested information for all sections. Be accurate and thorough to avoid delays in processing. Where no response is possible, please write or select N/A. Attachments and additional pages are not required unless specifically requested in the application.

Who Receives This Completed Application

Once this application is submitted, it will be received by the Chattanooga Office of Economic and Community Development.

Questions

Contact Jermaine Freeman, Director of Economic Programs at JFreeman@chattanooga.gov or call
423-643-7821.
Applicant Information - (*) indicates a required field.
Company/Name:(*)
Field is required.

Mailing Address:(*)
Field is required.

Address Line 2:
Invalid Input

City:(*)
Invalid Input

County:(*)
Field is required.

Zip Code:(*)
Invalid Input

State:(*)
Invalid Input

Job Title:
Invalid Input

Please enter phone numbers in the format ###-###-####.
Office Phone:(*)
Phone number must be in the format ###-###-####.

Mobile Phone:(*)
Phone number must be in the format ###-###-####.

Email:(*)
Please enter a valid email address.

Website:
Invalid Input

Legal business name under which application is made:
Invalid Input

Federal tax ID number:(*)
Field is required.

State of Formation:
Invalid Input

Service/Product produced:(*)
Field is required.

Compliance Information
Please list the applicant's officers and directors:(*)
Field is required.

Is the company registered to conduct business in Tennessee?(*)
Invalid Input

Please upload a Certificate of Authorization/Good Standing if the company has operated for one full year or more. For companies that have been in operation in Tennessee for less than one year upload either a Certificate of Existence or an Application for a Certificate of Authority/Existence. Please visit Tennessee Secretary of State Certificate of Existence page for more information.

Do you have a certificate available now?(*)
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Select Certificate file to upload:(*)
You must upload a certificate

Visit Trustee's Office web site for more tax payment information.

All ad valorem taxes have been paid?(*)
Invalid Input

Company has a business license in the City of Chattanooga?(*)
Invalid Input

All business taxes have been paid?(*)
Invalid Input

Please provide a written explanation if “no” has been selected on any of the questions above. After the Office of Economic and Community Development review the application, we will request the Company to provide documentation of all licenses, taxes paid, and other compliance information.
Explanation:(*)
Field is Required

Small Business Incentive Grant

Grant explanation

To meet the terms of the grant, Company must be engaged in a for-profit service or manufacturing industry; employ no more than 100 full-time persons, regardless of the locale in which they are employed; create a minimum of five (5) new full-time jobs within the City of Chattanooga; and create the jobs at the qualified project site within a contiguous twelve (12) month period.

Additional Information on Company

Date of First Qualified Hire Made(*)
Invalid Input

Number of employees on that start date: (Date must be on or after July 1, 2014)(*)
Input Must Be Numeric

Number of incremental employees hired during prior 12 month period beginning on start date:(*)
Input must be numeric

Please upload a spreadsheet or document listing general job classifications and how many jobs created in each category. In addition, list the hire date and wage rate for each new full-time position.
Invalid Input

Acknowledgment and Confirmation of Accuracy

Confirmation of Accuracy

To the best of my knowledge and belief, the information contained in this Chattanooga Application for Incentives is true and correct, as evidenced by my confirmation below. I further certify that the business entity is in good standing under the laws of jurisdiction(s) in which the entity organized or authorized to conduct business and that no delinquent taxes are owed to any taxing entity.

Furthermore, I understand the incentive will reimburse a Qualified Small Business for all or part of its documented expenditures related to the acquisition, preparation or occupancy of office space and other facilities with the City, costs of moving to or relocating within or to the City, costs associated with initial or on-going training of employees located at the Qualified Project Site, or other such costs or expenses.

I confirm the statements shown above to be true.(*)
Invalid Input

Dottie Brewer