La Hacienda Family Mexican Restaurant 12/28/2020

PART 3. GOVERNMENT, BANK AND OTHER FUNDING SOURCES Government, bank, and all other funding received by a business for COVID-19 Pandemic National Emergency related losses. Please identify any sources of funds that the business received as a result of the COVID-19 Pandemic National Emergency other than insurance. Sources of funds include but are not limited to: Federal,state and local loan/grant programs, private or bank loans, nonprofit donations or loans. Please indicate below the amount allocated to your business from any and all funding sources: Source of Funds #1 Lender/Grant Provider Name ' ` ill-- Purpose( o kt 'S , Amount t l f....L ❑ Government Loan 0140idettinkatititirVi Government Forgivable Loan ❑ Nonprofit Grant 0 Nonprofit Loan ❑ Nonprofit Forgivable Loan ❑ Private Loan 0 Other: Source of Funds#2 Lender/Grant Provider Name 4 " Purpose /ir Q . 1 v Amount '-" ��c�E et government Loan 0 Government Grant 0 Government Forgivable Loan El Nonprofit Grant ❑ Nonprofit Loan El Nonprofit Forgivable Loan ❑ Private Loan ❑ j Other: Source of Funds#3 Lender/Grant Provider Name Purpose —I I Amount ❑ Government Loan 0 Government Grant ❑Government Forgivable Loan ❑ Nonprofit Grant ❑ Nonprofit Loan 0 Nonprofit Forgivable Loan ❑ Private Loan ❑Other: Source of Funds#4 Lender/Grant Provider Name �~� .U,~+.+ ��»w,~�.�� .��. � Purpose Amount ❑Government Loan 0 Government Grant 0 Government Forgivable Loan ❑ Nonprofit Grant 0 Nonprofit Loan ❑ Nonprofit Forgivable Loan ❑ Private Loan 0 Other: vi EVERETT OMRWASHINGTON Everett CARES Sr all Business Grant Program Round 3 ` pale 1f)