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Certifications Intake

Certification Application - all questions are mandatory.

What certification would you like to apply for?

Women Owned Business (WBE)

Minority Owned Business (MBE)

Veteran Owned Business (VBA)

HUB Zone

SBA 7A

Other

Have you previously applied for any business certifications?*

Yes

No

Was the business denied for the previously applied certification?*

Yes

No

Why was the business denied?

Why are you applying for certifications?*

Business Information

Business Name*

Business Address*

Business Phone Number*

Business Email*

Business Website*

Business Facebook Link*

Business Instagram Link*

Business LinkedIn Link*

Business Start Date*

Employer Identification Number (EIN)*

State Registered In*

Type of Business Entity*

Sole Prop

LLC

Corp

LLC taxed as a Corp

Partnership or Non-Profit

Is your annual LLC or Corp registration up to date?*

Yes

No

NAICS Code Used On Taxes*

Number Of Business Owners*

Is the business a majority business owned (51% or more) by a woman? *

Yes

No

Is the business controlled and managed on a daily basis by women?*

Yes

No

Percentage of the business owned by women?*

Please give a brief description of the business and its operation.*

Owner 1 Information

Full Legal Name*

Percentage of Ownership *

Personal Address*

Date of Birth*

Social Security Number *

Personal Email*

Are you employed outside of the business?*

Yes

No

List all employment you have, position and salary, and start date outside of this business.*

Owner 2 Information

Full Legal Name

Percentage of Ownership

Personal Address

Date of Birth

Social Security Number

Personal Email

Are you employed outside of the business?

Yes

No

List all employment you have, position and salary, and start date outside of this business. (Case Partnership)

Owner 3 Information

Full Legal Name

Percentage of Ownership

Personal Address

Date of Birth

Social Security Number

Personal Email

Are you employed outside of the business?

Yes

No

List all employment you have, position and salary, and start date outside of this business. (Case Partnership)

Business Financial Information

Annual Gross Income last filed tax year?*

Number of Employees (Total)*

Number of Full Time Employees only?*

Number of Part Time Employees only?*

Number of Seasonal Employees or On Call?*

Number of Contractors?*

Does the business have a bank account?*

Yes

No

Are business financial statements up to date and avaliable ? (If NO, please email taxes@kingsandqueensconsultingllc.com for a quote to complete for you)*

Yes