Appendix G - BEN Loan Application~1.pdf

This is a Loan/Subsidy Application Form used by the Nevada Department of Employment, Training and Rehabilitation (DETR) Business Enterprises of Nevada (BEN) program to process financial assistance requests for blind and visually impaired business operators. The form captures essential applicant information including operator name, BEN number, loan or subsidy designation, and the requested amount, requiring applicants to describe the circumstances necessitating the financial assistance. The application must be submitted to the Business Enterprise Officer (BEO II) for initial review and forwarding to the Loan/Subsidy Review Panel. The form accommodates multiple entries for circumstances and includes designated approval or denial checkboxes at two decision points: first at the BEO II and Program Chief level, and second at the Administrator level for requests exceeding $10,000, with signature blocks and date fields throughout the review workflow.

The form establishes a structured internal review and approval process with no specific application deadlines indicated in the document itself. No pricing terms, set-asides, or incumbent information is contained within this application form, as it functions as an intake document rather than a solicitation document. All applications must include supporting documentation as deemed necessary by the applicant. The approval authority thresholds are clearly delineated, with requests of $10,000 or less requiring BEO II and Program Chief authorization, while larger requests mandate additional Administrator approval, ensuring appropriate oversight levels based on subsidy or loan amount.