Department of Commerce & Consumer Affairs

dcca.smallbusiness@barbados.gov.bb

1st Floor, Warrens Office Complex, Warrens, St. Michael

(246)535-7000

1st Floor, Warrens Office Complex, Warrens, St. Michael

(246) 535-7000

Reference No.

You will be provided with a Reference No. upon submission.

Application for Financial Assistance - Small or Micro Business owners

PERSONAL DETAILS (OWNER)

Address

Parish

Telephone number (home/work)

Telephone number (mobile)

National Registration Number

Email Address

BUSINESS DETAILS

Name of Business

Type of Business

Business Registration List (select the category for which you have a number)

Vendor No:

Company Registration No:

Business Name No:

Farmer's ID No:

Liquor License No:

NIS No:

TIN No:

Fund Access No.

Other

Other Business Registration information

Business registration number (enter the number for the category selected above. Eg. if you select Vendor No. enter the Vendor No here

Is address different from the address entered above?

Yes

Address

Parish

BANK/CREDIT UNION DETAILS

Do you have a bank/credit union account?

Yes

Bank or Credit Union

Account Number

Name on Bank Account

If you do not have a bank/credit union account, please contact:

Department of Commerce and Consumer Affairs

Telephone number: 535-7000

DECLARATION

I declare that:

by submitting this form all of the information that I have provided is true and correct.