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2. 
4. Additional funds are now available!
6. GPCOG Loan Application

   The Greater Portland Council of Government’s Revolving Loan Program is designed to provide financial assistance to small businesses to sustain and create jobs. Businesses located in Portland should contact the Portland Development Corporation. Businesses with one or more employees located elsewhere in GPCOG’s service area may apply for a loan.

8. Additional financial documentation may be required. Once this application is submitted, staff will contact you to explain how to submit the remaining documents.

10. Business Owner's Name*
12. Email Address*
13. Phone Number*
15. Full Business Address*
    Note physical address required, P.O. Boxes are not sufficient
17. City or Town*
18. State
19. Zip Code
21. Do you have a preferred language other than English?
25. Please list the Legal Business Name *
    Include DBA (doing business as) if different
27. City*
28. State
29. Zip Code
31. Business Structure

    1. Sole Proprietorship
    2. General Partnership
    3. Limited Partnership
    4. Limited Liability Company (LLC)
    5. Corporation
32. Date business first opened*
36. Revolving Loan Fund - GPCOG

    1+ employees (not including the owners); Businesses located in the Greater Portland region preferred; Terms: Up to $350,000 per business; Other restrictions and requirements apply.

40. How much money are you requeseting?
    Please note: Entrepreneur Assistance can request up to **$10,000.** Small Business Assistance for Job Creation/ Retention can request up to **$20,000.** These funds are forgivable. The Resilience Loan Program totals vary by location, see limits defined in the previous question. Revolving Loan fund requests can be up to $250,000.
42. How do you intend to use the funds? *

    1. Rent
    2. Utilities
    3. Payroll (excludes owner)
    4. Inventory

    1. Insurance
    2. Operations
    3. Other
46. Certification*
    To the best of my knowledge, the above information is accurate, and I (we) understand that any false or misleading information I (we)provide may lead to my (our) disqualification form this program. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature. Please type your name above as an electronic signature if you agree.
48. Credit Authorization and Confidentiality of Records*
    I (we) authorize the Greater Portland Council of Government to make whatever credit inquiries it deems necessary to verify the accuracy of the information provided in connection with the review of this application. I (we) hereby request that information provided by me (us) and developed by the Greater Portland Council of Government, or its staff or agents, with respect to this application for financial assistance be designated confidential and not open for public inspection, pursuant to 5 M.R.S.A. Section 13119 et sq. Certain records of the Greater Portland Council of Government are designated CONFIDENTIAL AND WILL NOT BE MADE AVAILABLE FOR PUBLIC INSPECTION. This includes the disclosure of tax or financial information; our assessment of creditworthiness or financial condition; records obtained by the Greater Portland Council of Government in connection with the monitoring or servicing of an existing project; proprietary information; and, information regarding the financial status of the application. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature. Please type your name above as an electronic signature if you agree.
52. Next Steps
    To continue this application, additional financial documentation is required. Staff will contact you to inform you how to submit.
Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit Submit and Print

* indicates a required field