"*" indicates required fields Step 1 of 3 33% Email* Name* First Please list your middle name if you have one. If you do not have one enter n/a. Last What program are you interested in applying for?* Build Fund Build Smart What will loan be used for:* Acquisitions New Construction Rehabilitation Equipment Working Capital - Only awarded in conjunction with: rehab, acquisitions, new construction, expansion program Personal Income Level*<$40,000-50,000$50,000-54,150$54,150-61,900$61,900-69,650$69,650-77,350$77,350-83,550$83,550-89,750$89,750-95,950$95,950-102,150$102,150+How many person(s) are actively living in your household?*12345678+Business Name*Legal Business NameHave you operated or owned a business with any other name?* No Yes What was the previous business name(s) used?*Legal Form* Corporation - C Limited Liability Corp Non-Profit Organization Other Partnership S-Corp Sole Proprietor Unknown Business Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Business Website Is this business certified with the State of Indiana as any of the following?*Check all that apply: Female-Owned Military Veteran-Owned Military Veteran-Owned Disadvantaged-Owned Hot Zone Opportunity Zone Enterprise Zone Start-up Home based Low income owned Not Certified Is this business certified with the City of Indianapolis as any of the following?*Check all that apply: Female-Owned Military Veteran-Owned Disability-Owned Disadvantaged-Owned Not Certified Industry* Agricultural Arts & Entertainment Comm. Group/CDC Commercial Distribution/Whsing Food & Beverage Institutional Investor/Developer Manufacturer Neighborhood Nonprofit Office Space Other R&D Retail Service Warehousing Wholesale Only What is your business' industry?*Loan amount requested?*Annual Business Revenue?*Is this business a start-up?* Yes No Please indicate the number of existing employees:*Projected number of jobs to be created?* Demographic InformationRace: Check one or more* American Indian / Alaskan Native American Indian / Alaskan Native & White American Indian / Alaskan Native / Black/African American Asian Asian & White Black/African American Black/African American & White Native Hawaiian/ Other Pacific Islander White Other, Multi-Racial Ethnicity: Hispanic or Latino* Yes No Sex:* Female Male Non-binary I do not wish to provide this information Veteran Status* I am a veteran I am not a veteran I do not wish to self-identify How did you hear about Build Fund or Intend Indiana?* Employee Referral Organization Referral Intend/Build Fund website Advertisement (post-card) Community Event Other Project PortfolioMax. file size: 50 MB.past work, present, and/or architectural plans for loan applicationFor Acquisition Loans - Purchase AgreementMax. file size: 50 MB.Business Plan or Lean CanvasMax. file size: 50 MB.Active Business License in Indiana from the Secretary of State*Max. file size: 50 MB.including either the article of incorporation and/or certificate of existenceCommentsThis field is for validation purposes and should be left unchanged.
