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Free Consultation

By submitting the following questionnaire you are requesting a consultant from Certify to Success to contact you for a FREE initial consultation. This initial consultation will last no longer than one hour and will provide a preliminary assessment of whether your company might be eligible for SBA�s 8(a) or SDB certification.

Please note that all information provided will be kept confidential. Once you have submitted the questionnaire, someone from Certify to Success will contact you within 24 hours.

ALL FIELDS MARKED WITH AN ASTERISK (*) ARE REQUIRED.

  
 
*Name  
Company
Position or Title
*Address  
*City  
*State & Zip Code  
*Telephone  
*Email Address  
What is the ownership structure of the company considering 8(a) or SDB certification?
Sole Proprietorship Partnership
Limited Liability Company Corporation
Other (please describe)
Please give a brief description of the main product/service the company provides.
Has this company ever been previously 8(a) certified? Yes No
Have any of the owner/applicant(s) whom 8(a) or SDB certification eligibility will be based on ever been previously 8(a) certified? Yes No
Are the owner/applicant(s) U.S. Citizens? Yes No
Are the owner/applicant(s) majority owners (51% ownership or greater) of the company? Yes No
Which of the following categories apply to the owner/applicant(s)?(Check as many as apply.)
Women Veteran
Minority Disabled
Other  
Which of the following certifications does your company currently hold? (Check as many as apply.)
Women Minority Hubzone
DBE State City
County None  
Has the company been in business for two or more years? Yes No
Is the company considered a small business by applicable size standards for your industry? [See Standards] Yes No
Do owner/applicant(s) work full-time (40 or more hours per week) in the business? Yes No
Do owner/applicant(s) have full and complete control of the company and all decisions made regarding the company? Yes No
Is this company operated for-profit? Yes No
Do the owner/applicant(s) have ownership interest of another business? Yes No
Are the owner/applicant(s) employed by any other company? Yes No
Have the owner/applicant(s) been subjected to discrimination in the U.S. because of race, ethnicity, gender, physical disability or geographical location of residence or upbringing? Yes No
Does owner/applicant or company have any past due or unpaid debts (taxes, loans, etc.) to the government? Yes No
If owner/applicant(s) answered yes to the above question can they supply proof that payment arrangements been made and payments are being kept current? Yes No Not Applicable
Is owner/applicant(s) of good moral character? Yes No
Is this company a brokerage firm? Yes No
Does this company have any joint venture, licensing, alliance or teaming agreements with other companies? Yes No
Excluding the value of the business and personal residence, does owner/applicant have a net worth of $250,000 or less? Yes No
Excluding the value of the business and personal residence, does owner/applicant have a net worth of $750,000 or less? Yes No