Small Business Exporter of the Year for 1999

2013 SMALL BUSINESS EXPORTER OF THE YEAR U.S. Small Business Administration Nomination Form Wisconsin District Office

Individuals who 1) own and 2) operate a small business engaged in exporting products or services outside of the United States may be nominated. SBA's size standards apply in defining a business as small.

Nomination packages must be complete. Nominations must be typewritten and signed. Financial information will be kept confidential. Complete and submit SBA Forms 3300 and consent form with nominations. Nominations are due December 7, 2012

Nominee's Full Name: ______Occupation/Title of Position: ______Name of Business: ______Business Address: ______Home Address: ______Telephone Number: (Business) ______(FAX) ______(Home) ______E-mail address: ______North American Industry Classification System (NAICS) Code: ______

Nominator's Name: ______Title: ______Name of Business or Organization: ______Address: ______Telephone: ______(FAX) ______E-mail: ______

Give a one-paragraph description of the nominee's business or profession/occupation (please include any SBA assistance nominee has received, this would include SCORE, SBDC counseling).

Nominator should submit a nomination letter (not to exceed a page) on why individual deserves recognition.

Please address the following criteria for Small Business Exporter of the Year (write up should not exceed four pages). In Evaluating the nomination packages, the judges will look at the following criteria: - 2 - I Increased sales, profits, and/or growth of employment because of exporting. Include total number of full-time and part-time employees:______. Please include gross revenues for past three years: 2009______2010______2011______This information is for the judges and is kept confidential.

II. Creative overseas marketing strategies, with a description of the products exported and markets served.

III. Effective solutions to export-related problems.

IV. Demonstrated encouragement of other small businesses to export.

V. Volunteer assistance to other small businesses entering the export market.

VI. Cooperation with other businesses in the creation of export trading companies, and/or introduction of unique trading relationships, products, or services.

SBA04 - 3 -

Financial Statement – information is confidential

2009 2010 2011

Balance Sheet

Current Assets ______

Total Assets ______

Current Liabilities ______

Total Liabilities ______

Net Worth ______

Income statement

Sales ______

Net Profits ______

(Profit and loss statements and balance sheets for the past three years will be required from the State winner).

Additional Information

All nominees and nominee's businesses must comply with state and federal regulations regarding labor, immigration, civil rights, taxation, and other applicable regulations. By submitting the completed nomination form, the nominee certifies that, to

SBA04 - 4 - the best of his/her knowledge, the information provided is correct and the business has complied with regulations, as stated above.

A Small Business Exporter will be selected as the state winner. The state winner would be asked for additional items for competition at the regional level. Three years of profit and loss and balance sheets will be required.

One black and white/color photo image of the winner and their business operation must be submitted. Digital photos are acceptable (w/300 dpi). The awards presentation will be held on May 31, 2012.

For further information on this award, call the Milwaukee Office, 414-297-1093.

______Date______Date______Nominator (signature) Nominee (signature)

Received at SBA District Office on ______by ______. (date) (staff)  SBA Form 3300

 Consent Form

Nominations must be received by December 7, 2012 U.S. Small Business Administration 310 W. Wisconsin Ave. Suite 400 Milwaukee, WI 53203

E-mail: [email protected]