Form 1-6b Microenterprise Business Project Summary Form
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1
2FORM 1-6B
MICROENTERPRISE BUSINESS PROJECT SUMMARY FORM
Section I – CDBG Recipient Information
Recipient Name
CDBG #
Section II – Business Information
Business Name
Business DUNS
Owner Name
Owner Name
Business
Address
NY
ZIP + 4
Type of Business
Total Number of Current Employees Including the Owner(s)
Date Business Owner Completed Entrepreneurial Training
Date Business was Awarded Microenterprise Assistance by Recipient
Is this a Start-Up or Existing Business?
Start-Up ○ Existing ○
Year Business Established
Is the Business Located in a NY Main Street Target Area Program?
Yes ○
No ○
Section III – National Objective Information
The business must meet one of the following in order to be eligible for a NYS CDBG
Microenterprise grant. Check whether the business will create at least one LMI job or if the
owner(s) qualify as low- to moderate-income. (Select LMJ or LMCMC)
○ LMJ- LOW/MOD CREATION 24 CFR 570.208(a)(4): Activities designed to create
permanent
FTE jobs, at least 51% of which employ LMI persons.
If LMJ:
○ Jobs will be made available to LMI Persons
○ Jobs will be held by LMI persons
○ LMCMC-LOW/MOD
LIMITED
CLIENTELE
MICROENTERPRISE
24
CFR
570.208(a)(2)(iii): Activities that are carried out under 24 CFR 570.201(o) and the owner(s)
/entrepreneur(s) are LMI persons.
Section IV – Job Information
If the business is proposing to meet the LMJ National Objective, complete the chart below for
each job title to be created.
Full – Time Jobs
Part – Time Jobs
Job Classification Title and Skills Required
Total #
Total #
Total #
Total #
LMI
LMI
Total
0
0
0
0
Average Number of Hours Worked Per Week for Part-Time Jobs:
6/2015
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