Form E1 - Lafayette Business Recovery Program

Lafayette Business Recovery Program - Form E1

Please include information below regarding the primary applicant and business. To be a primary applicant, you must be an owner of the business.
PROGRAM OVERVIEW

In response to economic hardships experienced by small businesses resulting from the COVID-19 pandemic, Lafayette Consolidated Government (LCG) and Lafayette Economic Development Authority (LEDA) have launched a business relief program to stabilize local businesses and retain/create jobs. LCG is accepting pre-applications in anticipation of receiving HUD funds.

Businesses may apply for a forgivable loan or grant of up to $10,000 to assist with up to three months of costs associated with qualifying unpaid business expenses incurred after March 27, 2020—including but not limited to rent, payroll, insurance, benefits, and utilities.

All personal and business financial information will be kept confidential to the extent permitted by law.

READ FIRST

After submitting this form you will receive a confirmation email with your unique Application ID and a copy of the information you submitted. This email will also contain a link to the next form you will need to complete in the application process.

If you do not receive this email, please check your spam folder or allow emails from do-not-reply@lafayette.org. For questions, please call 337-593-1400.

If you submit information you would like to keep private, please do not use a shared email address that multiple people can access.
Legal Name*

PrefixFirst NameMiddle NameLast NameSuffix
Phone Number*
Secondary Phone Number
E-mail*

Confirmation EmailIMPORTANT: All information entered in this form and subsequent forms will be sent to this email address and will be visible to anyone who has access to this email account. If you would like your information to remain private, please do not use a shared email account.
Business Name*
Provide DBA (if applicable)
Business Phone Number*
EIN (Employer Identification Number)
Please select the type of business/industry you operate in*

Agriculture, Forestry, Fishing and HuntingMining/Oil & GasUtilitiesConstructionManufacturingWholesale TradeRetail TradeTransportation and WarehousingInformationFinance and InsuranceReal Estate, Rental and LeasingProfessional, Scientific, and Technical ServicesManagement of Companies and EnterprisesAdministrative and Support and Waste Management and Remediation ServicesEducational ServicesHealth Care and Social AssistanceArts, Entertainment, and RecreationAccommodation and Food ServicesOther Services (except Public Administration)Public Administration
Please select the category your business falls within

Oilseed and Grain FarmingVegetable and Melon FarmingFruit and Tree Nut FarmingGreenhouse, Nursery, and Floriculture ProductionOther Crop FarmingCattle Ranching and FarmingHog and Pig FarmingPoultry and Egg ProductionSheep and Goat FarmingAquacultureOther Animal ProductionTimber Tract OperationsForest Nurseries and Gathering of Forest ProductsLoggingFishingHunting and TrappingSupport Activities for Crop ProductionSupport Activities for Animal ProductionSupport Activities for Forestry
Please select the category your business falls within

Oil and Gas ExtractionCoal MiningMetal Ore MiningNonmetallic Mineral Mining and QuarryingSupport Activities for Mining
Please select the category your business falls within

Electric Power Generation, Transmission and DistributionNatural Gas DistributionWater, Sewage and Other Systems
Please select the category your business falls within

Residential Building ConstructionNonresidential Building ConstructionUtility System ConstructionLand SubdivisionHighway, Street, and Bridge ConstructionOther Heavy and Civil Engineering ConstructionFoundation, Structure, and Building Exterior ContractorsBuilding Equipment ContractorsBuilding Finishing ContractorsOther Specialty Trade Contractors
Please select the category your business falls within

Animal Food ManufacturingGrain and Oilseed MillingSugar and Confectionery Product ManufacturingFruit and Vegetable Preserving and Specialty Food ManufacturingDairy Product ManufacturingAnimal Slaughtering and ProcessingSeafood Product Preparation and PackagingBakeries and Tortilla ManufacturingOther Food ManufacturingBeverage ManufacturingTobacco ManufacturingFiber, Yarn, and Thread MillsFabric MillsTextile and Fabric Finishing and Fabric Coating MillsTextile Furnishings MillsOther Textile Product MillsApparel Knitting MillsCut and Sew Apparel ManufacturingApparel Accessories and Other Apparel ManufacturingLeather and Hide Tanning and FinishingFootwear ManufacturingOther Leather and Allied Product ManufacturingSawmills and Wood PreservationVeneer, Plywood, and Engineered Wood Product ManufacturingOther Wood Product ManufacturingPulp, Paper, and Paperboard MillsConverted Paper Product ManufacturingPrinting and Related Support ActivitiesPetroleum and Coal Products ManufacturingBasic Chemical ManufacturingResin, Synthetic Rubber, and Artificial and Synthetic Fibers and Filaments ManufacturingPesticide, Fertilizer, and Other Agricultural Chemical ManufacturingPharmaceutical and Medicine ManufacturingPaint, Coating, and Adhesive ManufacturingSoap, Cleaning Compound, and Toilet Preparation ManufacturingOther Chemical Product and Preparation ManufacturingPlastics Product ManufacturingRubber Product ManufacturingClay Product and Refractory ManufacturingGlass and Glass Product ManufacturingCement and Concrete Product ManufacturingLime and Gypsum Product ManufacturingOther Nonmetallic Mineral Product ManufacturingIron and Steel Mills and Ferroalloy ManufacturingSteel Product Manufacturing from Purchased SteelAlumina and Aluminum Production and ProcessingNonferrous Metal (except Aluminum) Production and ProcessingFoundriesForging and StampingCutlery and Handtool ManufacturingArchitectural and Structural Metals ManufacturingBoiler, Tank, and Shipping Container ManufacturingHardware ManufacturingSpring and Wire Product ManufacturingMachine Shops; Turned Product; and Screw, Nut, and Bolt ManufacturingCoating, Engraving, Heat Treating, and Allied ActivitiesOther Fabricated Metal Product ManufacturingAgriculture, Construction, and Mining Machinery ManufacturingIndustrial Machinery ManufacturingCommercial and Service Industry Machinery ManufacturingVentilation, Heating, Air-Conditioning, and Commercial Refrigeration Equipment ManufacturingMetalworking Machinery ManufacturingEngine, Turbine, and Power Transmission Equipment ManufacturingOther General Purpose Machinery ManufacturingComputer and Peripheral Equipment ManufacturingCommunications Equipment ManufacturingAudio and Video Equipment ManufacturingSemiconductor and Other Electronic Component ManufacturingNavigational, Measuring, Electromedical, and Control Instruments ManufacturingManufacturing and Reproducing Magnetic and Optical MediaElectric Lighting Equipment ManufacturingHousehold Appliance ManufacturingElectrical Equipment ManufacturingOther Electrical Equipment and Component ManufacturingMotor Vehicle ManufacturingMotor Vehicle Body and Trailer ManufacturingMotor Vehicle Parts ManufacturingAerospace Product and Parts ManufacturingRailroad Rolling Stock ManufacturingShip and Boat BuildingOther Transportation Equipment ManufacturingHousehold and Institutional Furniture and Kitchen Cabinet ManufacturingOffice Furniture (including Fixtures) ManufacturingOther Furniture Related Product ManufacturingMedical Equipment and Supplies ManufacturingOther Miscellaneous Manufacturing
Please select the category your business falls within

Motor Vehicle and Motor Vehicle Parts and Supplies Merchant WholesalersFurniture and Home Furnishing Merchant WholesalersLumber and Other Construction Materials Merchant WholesalersProfessional and Commercial Equipment and Supplies Merchant WholesalersMetal and Mineral (except Petroleum) Merchant WholesalersHousehold Appliances and Electrical and Electronic Goods Merchant WholesalersHardware, and Plumbing and Heating Equipment and Supplies Merchant WholesalersMachinery, Equipment, and Supplies Merchant WholesalersMiscellaneous Durable Goods Merchant WholesalersPaper and Paper Product Merchant WholesalersDrugs and Druggists' Sundries Merchant WholesalersApparel, Piece Goods, and Notions Merchant WholesalersGrocery and Related Product Merchant WholesalersFarm Product Raw Material Merchant WholesalersChemical and Allied Products Merchant WholesalersPetroleum and Petroleum Products Merchant WholesalersBeer, Wine, and Distilled Alcoholic Beverage Merchant WholesalersMiscellaneous Nondurable Goods Merchant WholesalersWholesale Electronic Markets and Agents and Brokers
Please select the category your business falls within

Automobile DealersOther Motor Vehicle DealersAutomotive Parts, Accessories, and Tire StoresFurniture StoresHome Furnishings StoresElectronics and Appliance StoresBuilding Material and Supplies DealersLawn and Garden Equipment and Supplies StoresGrocery StoresSpecialty Food StoresBeer, Wine, and Liquor StoresHealth and Personal Care StoresGasoline StationsClothing StoresShoe StoresJewelry, Luggage, and Leather Goods StoresSporting Goods, Hobby, and Musical Instrument StoresBook Stores and News DealersDepartment StoresGeneral Merchandise Stores, including Warehouse Clubs and SupercentersFloristsOffice Supplies, Stationery, and Gift StoresUsed Merchandise StoresOther Miscellaneous Store RetailersElectronic Shopping and Mail-Order HousesVending Machine OperatorsDirect Selling Establishments
Please select the category your business falls within

Scheduled Air TransportationNonscheduled Air TransportationRail TransportationDeep Sea, Coastal, and Great Lakes Water TransportationInland Water TransportationGeneral Freight TruckingSpecialized Freight TruckingUrban Transit SystemsInterurban and Rural Bus TransportationTaxi and Limousine ServiceSchool and Employee Bus TransportationCharter Bus IndustryOther Transit and Ground Passenger TransportationPipeline Transportation of Crude OilPipeline Transportation of Natural GasOther Pipeline TransportationScenic and Sightseeing Transportation, LandScenic and Sightseeing Transportation, WaterScenic and Sightseeing Transportation, OtherSupport Activities for Air TransportationSupport Activities for Rail TransportationSupport Activities for Water TransportationSupport Activities for Road TransportationFreight Transportation ArrangementOther Support Activities for TransportationPostal ServiceCouriers and Express Delivery ServicesLocal Messengers and Local DeliveryWarehousing and Storage
Please select the category your business falls within

Newspaper, Periodical, Book, and Directory PublishersSoftware PublishersMotion Picture and Video IndustriesSound Recording IndustriesRadio and Television BroadcastingCable and Other Subscription ProgrammingWired and Wireless Telecommunications CarriersSatellite TelecommunicationsOther TelecommunicationsData Processing, Hosting, and Related ServicesOther Information Services
Please select the category your business falls within

Monetary Authorities-Central BankDepository Credit IntermediationNondepository Credit IntermediationActivities Related to Credit IntermediationSecurities and Commodity Contracts Intermediation and BrokerageSecurities and Commodity ExchangesOther Financial Investment ActivitiesInsurance CarriersAgencies, Brokerages, and Other Insurance Related ActivitiesInsurance and Employee Benefit FundsOther Investment Pools and Funds
Please select the category your business falls within

Lessors of Real EstateOffices of Real Estate Agents and BrokersActivities Related to Real EstateAutomotive Equipment Rental and LeasingConsumer Goods RentalGeneral Rental CentersCommercial and Industrial Machinery and Equipment Rental and LeasingLessors of Nonfinancial Intangible Assets (except Copyrighted Works)
Please select the category your business falls within

Legal ServicesAccounting, Tax Preparation, Bookkeeping, and Payroll ServicesArchitectural, Engineering, and Related ServicesSpecialized Design ServicesComputer Systems Design and Related ServicesManagement, Scientific, and Technical Consulting ServicesAdvertising, Public Relations, and Related ServicesResearch and Development in the Social Sciences and HumanitiesOther Professional, Scientific, and Technical Services
Please select the category your business falls within

Management of Companies and Enterprises
Please select the category your business falls within

Office Administrative ServicesFacilities Support ServicesEmployment ServicesBusiness Support ServicesTravel Arrangement and Reservation ServicesInvestigation and Security ServicesServices to Buildings and DwellingsOther Support ServicesWaste CollectionWaste Treatment and DisposalRemediation and Other Waste Management Services
Please select the category your business falls within

Elementary and Secondary SchoolsJunior CollegesColleges, Universities, and Professional SchoolsBusiness Schools and Computer and Management TrainingTechnical and Trade SchoolsOther Schools and InstructionEducational Support Services
Please select the category your business falls within

Offices of PhysiciansOffices of DentistsOffices of Other Health PractitionersOutpatient Care CentersMedical and Diagnostic LaboratoriesHome Health Care ServicesOther Ambulatory Health Care ServicesGeneral Medical and Surgical HospitalsPsychiatric and Substance Abuse HospitalsSpecialty (except Psychiatric and Substance Abuse) HospitalsNursing Care Facilities (Skilled Nursing Facilities)Residential Intellectual and Developmental Disability, Mental Health, and Substance Abuse FacilitiesContinuing Care Retirement Communities and Assisted Living Facilities for the ElderlyOther Residential Care FacilitiesIndividual and Family ServicesCommunity Food and Housing, and Emergency and Other Relief ServicesVocational Rehabilitation ServicesChild Day Care Services
Please select the category your business falls within

Performing Arts CompaniesSpectator SportsPromoters of Performing Arts, Sports, and Similar EventsAgents and Managers for Artists, Athletes, Entertainers, and Other Public FiguresIndependent Artists, Writers, and PerformersMuseums, Historical Sites, and Similar InstitutionsAmusement Parks and ArcadesGambling IndustriesOther Amusement and Recreation Industries
Please select the category your business falls within

Traveler AccommodationRV (Recreational Vehicle) Parks and Recreational CampsRooming and Boarding Houses, Dormitories, and Workers' CampsSpecial Food ServicesDrinking Places (Alcoholic Beverages)Restaurants and Other Eating Places
Please select the category your business falls within

Automotive Repair and MaintenanceElectronic and Precision Equipment Repair and MaintenanceCommercial and Industrial Machinery and Equipment (except Automotive and Electronic) Repair and MaintenancePersonal and Household Goods Repair and MaintenancePersonal Care ServicesDeath Care ServicesDrycleaning and Laundry ServicesOther Personal ServicesReligious OrganizationsGrantmaking and Giving ServicesSocial Advocacy OrganizationsCivic and Social OrganizationsBusiness, Professional, Labor, Political, and Similar OrganizationsPrivate Households
Please select the category your business falls within

Executive, Legislative, and Other General Government SupportJustice, Public Order, and Safety ActivitiesAdministration of Human Resource ProgramsAdministration of Environmental Quality ProgramsAdministration of Housing Programs, Urban Planning, and Community DevelopmentAdministration of Economic ProgramsSpace Research and TechnologyNational Security and International Affairs
Industry Code
BIZ Code
NOTE

After submitting this form you will receive a confirmation email with your unique Application ID and a copy of the information you submitted. This email will also contain a link to the next form you will need to complete in the application process.

If you do not receive this email, please check your spam folder or allow emails from do-not-reply@lafayette.org. For questions, please call 311 or 337-769-4091.

If you submit information you would like to keep private, please do not use a shared email address that multiple people can access.
I hereby certify that the information contained on this form is accurate and complete to the best of my knowledge, under penalty of law.
Should be Empty:

Lafayette Business Recovery Program - Form E1