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    Applicant/Business Owner


    Community Development Block Grant (CDBG) Eligibility

    The business applicant must meet the CDBG eligibility requirement:
    The business owner’s current household income is at or below 80% of the Orange County median income, adjusted for household size; OR
    The business intends to retain at least one full-time equivalent, permanent low- and moderate-income job and the business owner(s):
    Can show that 51% of its employees are low- and moderate-income, full-time or equivalent employees; and
    Agrees that the grant funds provided will ensure permanent employment of the retained employee for a period of two years; and
    Agree that if the low- and moderate-income job retained under this program is vacated within two years of the date of assistance, the business will take the necessary steps to fill the position with another low- and moderate-income employee for two years following the date of assistance.

    gross income

    Employees working in the business (as of December 31, 2019):

    Identify the number of employees

    Employees working in the business (as of March 31, 2020):

    Identify the number of employees

    Total Gross Revenue:

    How will you use the Buena Park Grant funds? (Please list out by amount, up to $10,000)


    Acknowledgement: I/We understand that this grant is being provided by the City of Buena Park based solely upon the information that you have provided in this application. I am also verifying that there are no outstanding tax liens or legal judgments against the business.

    Certification: I/We certify that the information provided in this application is true and complete to the best of my knowledge as of the date set forth opposite my/our signature(s) in this application and acknowledge my/our understanding that any intentional or negligent misrepresentation(s) of the information contained in this application may result in civil liability and/or criminal penalties.

    I/We also agree that this application authorizes the City to verify all sources of incomes and/or including, but limited to, the submittal of a request to the Employment Development Department/Unemployment Agency to verify any unemployment benefits currently being received by the business owner.

    I/We also agree that this form authorizes the City to verify the business owner(s) Small Business Administration (SBA) loans/ grants received for this business in connection with coronavirus pandemic and/or CARES Act.

    By signing below, I certify that the above statements are true and correct to the best of my knowledge. I understand that a false statement may disqualify me from benefits.


    The following information is requested by the Federal Government for certain types of loans and grants related to a dwelling, in order to monitor the Lender's compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. The law provides that the Lender may neither discriminate on the bases of this information, nor on whether you choose to furnish it. However, if you choose not to furnish it under Federal regulations this Lender is required to note race and sex on the bases of visual observation of surname. If you do not wish to furnish the information, please check the box below. (Lender must review the above material to ensure that the disclosure satisfy all requirements to which the Lender is subject under applicable state law for the particular type of loan applied for). 




    Need Some Help? The SBDC is Here!

    Don’t forget the SBDC is here to help you work through any of the questions on this application and the coinciding documentation – at no cost. Give us a shout and we’ll get back to you as soon as possible to help you work through this application.

    1-800-616-7232 or Sign Up Here

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    Mike Daniel is the network director of the Orange County Inland Empire SBDC Network, which assists aspiring entrepreneurs and current business owners throughout Orange, San Bernardino and Riverside counties. Mike was formerly the director of the SBDC office at Long Beach City College. As business owner and entrepreneur himself, he started his career as the owner of a Rocky Mountain Chocolate Factory location in Manhattan Beach and went on to open a second location in Long Beach in 2001. In 2007, Mike sold the Manhattan Beach store for an above-market offer then invested in several additional locations as a minority shareholder. Mike further expanded his candy empire with venture located in Shoreline Village in Long Beach called Sugar Daddies Sweet Shoppe, based on fill-it yourself candy options.

    Mike has a bachelor’s degree in Business Administration from California State University, Fullerton.