Community Economic Development Law Project

SMALL BUSINESS PROGRAM ELIGIBILITY STANDARDS In determining whether an individual is eligible for pro bono legal services, the Community Law Project will consider many factors. Some of these factors are:

. Access to credit, capital, legal resources and other resources you may need to grow and start a small business . Number and quality of jobs created for local residents . Benefit to a low income or traditionally underserved community . Household Income (see below)

Household Income Eligibility Criteria: * Incomes are based upon the 2016 Area Median Income (AMI) chart. Household income includes the income of all adults in the household. If the reported income is above 80 % of Area Median Income for the Chicago Metro Area but the other factors indicate that the business will benefit a low income or traditionally underserved community, create jobs for local residents, and/or the owners traditionally have had limited access to credit, capital and legal resources, the business will be considered for eligibility. 80% - Chicago Metropolitan Area Median Income Limits Size of Maximum Gross Household Household Income Per Year 1 $43,050 2 $49,200 3 $55,350 4 $61,500 5 $66,450 Referral: Applicants must also meet one of the following criteria:

. Referral by a community based organization; . Participation in a small business development training program sponsored by a community based organization; or demonstrate sufficient business experience to waive the training requirement; . Have a written business plan if you are starting a business. If you submit the application without the business plan, we will return the fee and application to you. If you need assistance with the preparation of a business plan, you may

Revised: July 2017 1 consider contacting one of the Technical Assistance Agencies listed on the last page.

Area of Legal Services Requested: The nature of the legal services provided are limited to transactional non-litigation legal services including, but not limited to, general legal advice/counsel, forming and/or operating a business, contract review/development, review of commercial leases, trademarks or copyrights and employment issues. No litigation services are provided.

Revised: July 2017 2 SMALL BUSINESS PROGRAM LEGAL ASSISTANCE APPLICATION

The $35.00 nonrefundable application fee (cash, money order or cashier’s check) must be submitted with the application . The application cannot be processed until the application fee has been received. If you submit the application for a startup without the business plan, we will return the fee and application to you. A separate fee will be charged for each request for legal assistance received more than twelve months from the date of the first request.

PART I: GENERAL INFORMATION

Your Name:______Address: ______City: ______State: ______Zip: ______Home Phone: (____)______Business Phone: (____)______Cell Phone: (____)______E-mail:______Website: ______

Statistical Information: The Community Law Project is a not-for-profit service organization that is dependent on funding from government, corporate and private sources. Without this support we would not be able to provide you with legal advice and representation. To apply for funding, the Community Law Project must supply statistics on its clients. Please check (√) the appropriate spaces: Race: Gender:  Asian  African American   Male  Female Latino/Hispanic  White  Native American  Other ______We occasionally need to use non-confidential information about our clients and their cases in public relations materials. May we release your name and non-confidential information about your case for such purposes? Yes ____ No _____

PART II: BUSINESS INFORMATION

You are seeking legal assistance for your current business or a business you are starting, answer the following questions about this business. NOTE: Please attach a copy of your business plan if you are starting a new business. 1. Business Revised: July 2017 3 Name:______2. Business Address: ______Identify the neighborhood where the business is located.______3. What service or product does your business provide? Please check (√) one.

 Arts, Entertainment, and  Educational Services  Finance and Insurance Recreation  Health Care and Social   Professional, Scientific, and Assistance Production/Distribution/Rep Technical Services air  Restaurant/Food Services  Retail  Real Estate and Leasing

 Declined to State  Other: ______

PART III. If you are currently conducting business, answer the following questions. If not, skip to Part IV.

1. Please attach copies of any formation documents-such as an assumed name certificate, articles of incorporation and bylaws or partnership agreement.

2. Are you conducting business as a  Sole Proprietor  Partnership  Corporation  Other Entity Please check (√) one. 3. When did you start doing business? ______4. How many employees do you currently employ? ______5. Do you have any outstanding leases? ____ yes ____ no If yes, please list and submit a copy of the lease. 6. Did your business have any revenue last year? Yes _____ No _____ (a) If yes, what was the total amount? $______(b) If yes, what is the revenue for your business to date (total for all years in business)? $______

PART IV. LEGAL ASSISTANCE

1. Briefly describe the nature of your legal problem. (Examples: contract review or preparation, need to incorporate, employee problems, review of lease, licensing problems, trademark/copyright issues). Please submit a copy of relevant documents with this application. ______Revised: July 2017 4 ______2. Have you consulted an attorney concerning any of the above matters? Yes ____ No ____ (a) If yes, please provide the name, address and telephone number of the attorney consulted: ______(b) Was the attorney paid? Yes ____ No ____ (c) Why are you not continuing to pursue this matter with the attorney consulted? ______3. Please identify the organization/person that referred you to the Community Law Project______PART V: FINANCIAL INFORMATION

Your application will not be considered without the following financial information: 1. What is the total annual gross income from all members of your household? $ ______(a) What is your gross annual income? $ ______(b) What is the source of your income? ______(c) Please list the following information for other household members: Member: ______gross income: $______Source:______Member: ______gross income: $______Source:______(d) How many people are in your household? ______

2. Is your business being financed in part or in full by a source other than yourself? Yes ___ No ___

(a) If yes, by whom? (Examples: family members, friends, banks, grants) Please list: ______3. Have you applied for any loans to finance your business? Yes _____ No _____ If yes, from what financial institution(s)? ______4. Do you have any partners in your business? Yes _____ No _____ (a) if yes, list the following:

Revised: July 2017 5 Name: ______Total annual gross household income $______Name: ______Total annual gross household income $______Name: ______Total annual gross household income $______

5. Please include any other information, including how you meet our eligibility standards that would assist us in evaluating your application for assistance from the Community Law Project ______

I hereby certify that all of the information in this application is true to the best of my knowledge. understand that the Community Law Project may use this information in evaluating my eligibility for free legal services.

By signing this form you are agreeing that the information you provided to the Community Law Project may be disclosed to attorney/volunteers in efforts to recruit pro bono assistance for your business. You also agree that the Community Law Project may disclose information about your business to our funders.

Signature: ______Date: ______

Please return this completed form and direct all questions to:

Community Law Project 100 North LaSalle Street, Suite 600 Chicago, IL 60602 Phone: (312) 939-3638 Fax: (312) 630-1127 Email: [email protected]

Revised: July 2017 6 TECHNICAL ASSISTANCE AGENCIES

Bethel’s Entrepreneurship Training Program Bethel New Life 4950 W. Thomas Chicago, Illinois 60651 Phone: 773/473-7870 Fax: 77/473-7871 Email: [email protected] Website: http://www.bethelnewlife.org/our- investments/community-economic- development/entrepreneurship- training-program/

Duman Microenterprise Center and Loan Fund Website: www.jvschicago.org/duman/ E-mail: [email protected] For information or to schedule an appointment, call (312) 673-3429

Knapp Entrepreneurship Center Illinois Institute of Technology 10 W. 35th Street Chicago, IL 60616 Phone: 312-567-3893 http://web.iit.edu/knapp-center

SCORE Chicago 500 W. Madison, Suite 1150 Chicago, Illinois 60661 (312) 353-7723 www.scorechicago.org

Revised: July 2017 7 Women’s Business Development Center 8 S. Michigan Avenue – Suite 400 Chicago, Illinois 60603 (312) 853-3477 www.wbdc.org

Revised: July 2017 8