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Small Business Emergency Assistance Program <br />Economic Development Commission; 8-5-20 <br /> <br /> <br />Page 9 <br />14. Itemized Budget <br /> <br /> Annual March April May <br />Rent: <br />Utility: <br />Utility: <br />Vendor 1: <br />Vendor 2: <br /> <br /> <br /> <br />Sources of Funds / Grants <br />SBA-EIDL: <br />SBA-PPP: <br />State: <br />County: <br />City: <br />Other: <br /> <br />15. Is this statement true: The applicant’s business is not a corporate or multi-state chain, or one that derives <br />income from gambling, adult entertainment, registered lobbying, billboards, passive investments, real estate <br />transactions, property rentals or property management? <br /> Yes: ______________ <br /> No: ______________ <br />16. Race of owner. <br /> ___________ White/Caucasian __________ Black/African American <br /> ___________ American Indian/Native Alaskan __________ Multi-Facial <br /> ___________ Asian __________ Prefer not to answer <br /> ___________ Hispanic/Latin <br />17. Gender of owner. <br /> ___________ Male <br /> ___________ Female <br /> ___________ Non-binary and/or gender non-conforming <br /> ___________ Another Gender Identify <br /> ___________ Prefer not to answer <br />