This application must be filled out, submitted and approved by the program administrator. The Office of Communications, Marketing and Economic Development will review application submittals and provide a determination of eligibility responses to applicants. An oversight review team, consisting of City staff and/or an outside service provider for administrative assistance, will determine eligible applications and make final decisions through a lottery system on whom will be awarded.
Please describe names and titles of current employees (including owner(s)).
RELEASE: I hereby authorize the City of Hollywood to release nonpublic personal information it obtains about me to my creditors and any third parties necessary to provide me with the services I requested. I acknowledge that I have read and understand the above privacy practices and disclosures.
OPT-OUT: I request that the City of Hollywood make no disclosures of my non-public personal information to third parties other than those permitted by law. By choosing this option, I understand that the City of Hollywood will NOT be able to answer any questions from my creditors. I understand that I may change my decision any time by contacting the City of Hollywood.
Documents may include year-to-date profit and loss statement through March 31st, the most recent 6 months of bank statements (summary page only), a notice of business closure, or other verifiable method to prove the revenue loss.
The business must provide copies of the submitted applications and documentation as well as the status of these applications (pending/approved/denied).
This field is not part of the form submission.
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