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2. The American Rescue Plan Act (ARPA) Small Business Emergency Relief Program was approved by the Hyattsville City Council to provide economic relief to small business owners in Hyattsville. The fund includes $1.5 million to support Hyattsville-based small businesses. Eligible applicants who are suffering financial hardships due to COVID-19 are encouraged to apply. 

   Funds will be awarded on a first-come, first-served basis. Applicants must be able to provide proof of eligibility for the grant program. There are no restrictions on the use of grant funds, if awarded.

   For assistance with this application, please review the Frequently Asked Questions at: www.hyattsville.orgs/rescueplan

   Please contact Small Business Recovery Coordinator Krissi Humbard at khumbard@hyattsville.org or (301) 789-7680 for questions. Please allow up to 30 calendar days to process grant applications. 

   Para ver esta información en español, seleccione el boton 'select language' ubicada abajo de esta pagina. 

4. General Information
6. Hyattsville Business Name:*
8. Business Legal Name, if different than above
10. Contact Person:*
12. Business Street Address:*
13. Suite #:
15. City, State, Zip:*
17. Phone #:*
18. Alternate Phone #:
20. Email Address:*
22. Number of Employees:*
24. Description of your business:*
26. In February 2020, was the business fully operational or were you, as an Independent Contractor in the personal care services industry, providing services within the City of Hyattsville? *

    1. Yes

    1. No
28. As of the date of the application, is your business fully operational or are you, as an Independent Contractor in the personal care services industry, providing services within the City of Hyattsville? *

    1. Yes

    1. No
30. YOUR BUSINESS IS NOT ELIGIBLE

    1. I understand I am not eligible.

    The Small Business Emergency Relief Program is only available to businesses or Independent Contractors that were operating in February 2020 and are currently in operation. 

    By selecting "No," you have indicated you are not eligible for the Small Business Emergency Relief Program.

32. Upload Form W-9*

    All applicants are required to submit a federal Form W-9 in order to receive payment. You can download a copy of the form at: https://www.irs.gov/pub/irs-pdf/fw9.pdf

34. Awards and Award Correspondence will be mailed to the business address listed above. If you'd like mail sent to a different address, enter that here:
36. Do you have a Business License with the City of Hyattsville?*

    1. I Have a License
    2. I Do Not Have a License

    NOTE: If you own a daycare, you are required to have a state childcare license for this grant program.

38. Get a Business License

    A City of Hyattsville Business License is required to receive awards under the Small Business Emergency Relief Program.

    If you do not have a City of Hyattsville Business License, please contact Krissi Humbard, Small Business Recovery Coordinator, at khumbard@hyattsville.org or 301-789-7680.

    1. I would like for a City staff member to contact me about obtaining a Business License.
42. Select the type of assistance you are requesting. “Small business” means that you operate a separate business entity and have fewer than 250 employees. “Independent Contractor in Personal Care Services” means that you are self-employed (e.g., not employed by a business) in a barber shop, beauty salon, nail salon, tattoo shop, or other personal care service.*

    1. Small Business
    2. Independent Contractor in Personal Care Services Industry (NAICS 8121)

    CHECK ONLY ONE BOX

44. Please indicate the type of financial harm your business experienced due to COVID-19.*

    1. Decrease in Revenues
    2. Decrease in Net Profits
    3. Experienced a Net Operating Loss
    4. Did not experience financial harm
46. Please select the appropriate industry in which your small business operates.*

    1. Arts, Entertainment, and Recreation Industry (NAICS 71); independent artists, writers, and performers; performing arts companies
    2. Accommodation and Food Services Industry (NAICS 72); restaurants, casual eateries, breweries, bars
    3. Personal Care Services Industry (NAICS 8121); beauty salons, barber shops, nail salons, massage studios, tattoo studios
    4. Other Industry

    CHECK ONLY ONE BOX

48. Please upload the complete 2019 Federal tax return for your business here.*
49. Please upload the complete 2020 Federal tax return for your business here.*
51. Please upload the complete 2021 Federal tax return for your business here.*
55. Was 50% or more of your gross income in 2020 or 2021 from Independent Contractor personal care services provided within the City of Hyattsville?*

    Individuals with less than 50% of income derived from personal care services are not eligible for this program. 

    1. Yes

    1. No
57. Please upload 2020 Federal Tax Return (including all schedules)*
58. Please upload 2021 Federal Tax Return (including all schedules)*
60. Please upload copies of any Form 1099s from businesses within the City of Hyattsville for 2020 and/or 2021*
61. Please upload 2019 Federal Tax Return (including all schedules)
63. Optional: Upload additional evidence of Independent Contractor income derived from work within the City of Hyattsville
67. Please provide evidence that you were providing services within the City of Hyattsville in February 2020 and at the date of the application. Documentation may include any one of the following:*

    1. Signed letter from the owner(s) of the business(es) that affirms you were providing services in February 2020 and as of the date of the application. The letter must contain the business address.
    2. Copy of an executed lease for property within the City with a lease term that includes February 2020 and the date of the application.
    3. Other evidence that proves you were providing the services within the City in February 2020 and the date of the application.
69. Upload Documentation Here:*
71. Optional: Upload Additional Documentation Here:
75. CERTIFICATION: The information provided in the application and this self-certification form are collected to determine if my business or myself as an Independent Contractor is eligible to receive assistance provided through the Federally-funded City of Hyattsville Small Business Emergency Relief Program. I certify that all the information provided in this application is correct and complete to the best of my knowledge, including all information regarding my business or myself as an Independent Contractor. I understand that providing false statements constitutes an act of fraud and is grounds for termination of assistance and is punishable under Federal and State of Maryland laws. I understand the information provided in my application may be shared with the United States Department of Treasury and other appropriate Federal agencies responsible for oversight of Federal funds. I consent to the program contacting other businesses who may have provided letters as additional documentation to verify the information provided in my application.​*
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77. 1. Receive an email copy of this form.
78. Email address

    This field is not part of the form submission.

79. Submit

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