State Small Business Credit Initiative 

Technical Assistance (TA) Application 5 .1 - Program Design 

I Eligible Recipient I 

Please use pages 1 through 12 to describe the project for which you will use TA Grant 

Program funds. 

SECTION 1: Data-driven assessment of the needs of eligible beneficiaries in the eligible 

recipient's jurisdiction. Eligible recipients must provide information and data that they have 

used to design their TA projects in a way that effectively addresses eligible beneficiaries' 

needs, particularly information and data on barriers to capital access. Information and data may 

include information from organizations and businesses associated with eligible beneficiaries; 

historical records and research reports on the need for small business legal, accounting, and 

financial advisory services in the jurisdiction; and statistical data on local economic conditions 

such as unemployment or job-creation numbers. 

OMB Control #: 1505-0227 

Expiration Date: 7/31/2025 

1 
State Small Business Credit Initiative 

Technical Assistance (TA) Application 

I Eligible Recipient I 

SECTION 1 (continued): 

OMB Control #: 1505-0227 

Expiration Date: 7/31/2025

5 .1 - Program Design 

2 
State Small Business Credit Initiative 

Technical Assistance (TA) Application 

I Eligible Recipient I 

SECTION 1 (continued): 

OMB Control #: 1505-0227 

Expiration Date: 7/31/2025

5 .1 - Program Design 

3 
State Small Business Credit Initiative 

Technical Assistance (TA) Application 

I Eligible Recipient I 

5 .1 - Program Design 

SECTION 2: The organizational capacity and ability of the TA providers. Eligible recipients 

must describe the proposed TA providers and, if applicable, the process for identifying future 

TA providers, such as eligible recipients' procurement processes. Eligible recipients must 

discuss their capability to directly implement the TA project or to manage subrecipient or 

contractor implementation. Eligible recipients must also discuss any subrecipient's or 

contractor's capability to implement the TA project or to manage the implementation oflowertier subrecipients or contractors. Eligible recipients must discuss the process, sources, and tools 

used in identifying and determining the capability of the TA providers. Eligible recipients must 

address requirements set forth under "TA Provider Requirement: Connection to Economic 

Benefits' in Section V.b and "TA Provider Requirement: Prioritization of SEDI-Owned 

Businesses as Providers" in Section V.c of the TA Grant Program Guidelines. 

OMB Control #: 1505-0227 

Expiration Date: 7/31/2025 

4 
State Small Business Credit Initiative 

Technical Assistance (TA) Application 

I Eligible Recipient I 

SECTION 2 (continued): 

OMB Control #: 1505-0227 

Expiration Date: 7/31/2025

5 .1 - Program Design 

5 
State Small Business Credit Initiative 

Technical Assistance (TA) Application 

I Eligible Recipient I 

SECTION 2 (continued): 

OMB Control #: 1505-0227 

Expiration Date: 7/31/2025

5 .1 - Program Design 

6 
State Small Business Credit Initiative 

Technical Assistance (TA) Application 

I Eligible Recipient I 

5 .1 - Program Design 

SECTION 3: The connection between the TA project and SSBCI or other program that 

supports small businesses. Eligible beneficiaries are VSBs and SEDl-owned businesses that are 

applying for, preparing to apply for, or previously applied for an SSBCI capital program or 

other federal or other jurisdiction small business program. Accordingly, eligible recipients must 

describe how the project is connected to the relevant small business programs. For example, 

where an eligible recipient's capital program is focused on capital access for small 

manufacturing enterprises (SMEs), the eligible recipient's TA Grant Program application should 

include information connecting TA projects to the needs of SMEs that are SEDI-owned 

businesses and VSBs applying for an SSBCI program or other federal or other jurisdiction small 

business program. This could include information on how the planned TA services are expected 

to help SME eligible beneficiaries to, for example, implement new technologies, build 

relationships with local distributors, or reduce energy costs. 

OMB Control #: 1505-0227 

Expiration Date: 7/31/2025

7 
State Small Business Credit Initiative 

Technical Assistance (TA) Application 

I Eligible Recipient I 

SECTION 3 (continued): 

OMB Control #: 1505-0227 

Expiration Date: 7/31/2025

5 .1 - Program Design 

8 
State Small Business Credit Initiative 

Technical Assistance (TA) Application 

I Eligible Recipient I 

SECTION 3 (continued): 

OMB Control #: 1505-0227 

Expiration Date: 7/31/2025 

5 .1 - Program Design 

9 
State Small Business Credit Initiative 

Technical Assistance (TA) Application 

I Eligible Recipient I 

5 .1 - Program Design 

SECTION 4: The strategy and efforts to reach SEDI-owned businesses and VSBs that are 

eligible beneficiaries. Eligible recipients should describe their strategy and efforts to reach 

eligible beneficiaries, such as regular internal organization meetings to assess TA project 

implementation and planned outreach efforts ( e.g., publicity, email campaigns, 

neighborhood canvassing). 

OMB Control #: 1505-0227 

Expiration Date: 7/31/2025 
State Small Business Credit Initiative 

Technical Assistance (TA) Application 

I Eligible Recipient I 

SECTION 4 (continued): 

OMB Control #: 1505-0227 

Expiration Date: 7/31/2025

5 .1 - Program Design 

11 
State Small Business Credit Initiative 

Technical Assistance (TA) Application 

I Eligible Recipient I 

SECTION 4 (continued): 

OMB Control #: 1505-0227 

Expiration Date: 7/31/2025

5 .1 - Program Design 

12 
State Small Business Credit Initiative 

Technical Assistance (TA) Application 

I Eligible Recipient I 

5.lA- Performance Goals

Please use pages 1 through 3 to describe the performance goals for the TA program. 

Eligible recipients must describe their performance goals and benchmarks for their TA Grant Program 

award. Treasury expects the duration of the period of performance for TA Grant Program awards will 

be up to five years. The performance measures must be tied to addressing the needs of eligible 

beneficiaries and explain the approach to addressing those needs. Eligible recipients must explain the 

output measures they will use to measure performance and the benchmarks for all identified short-, 

medium-, or long-term goals. Examples of output measures may include the number of newly 

established business organizations or the number of successful small business program applications 

OMB Control # 1505-0227 

Expiration Date: 7/31/2025 

1 
State Small Business Credit Initiative 

Technical Assistance (TA) Application 

I Eligible Recipient I 

Performance Goals (continued): 

OMB Control #: 1505-0227 

Expiration Date: 7/31/2025

5.lA- Performance Goals

2 
State Small Business Credit Initiative 

Technical Assistance (TA) Application 

I Eligible Recipient I 

Performance Goals (continued): 

OMB Control #: 1505-0227 

Expiration Date: 7/31/2025 

5.lA- Performance Goals

3 
SSBCI TECHNICAL ASSISTANCE APPLICATION 

Detailed Budget and Narrative Justification 

Applicant I xxxxxxxxx 

Agreement/ Amendment Number or Federal Award xxxxxxx Identification Number (FAIN) 

Date Submitted lxxxxx xx, 20xx

SSBCI TA Application Applicant lnfonnation_page 1 

Legend: 1-

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tat

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F

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iel

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d ______ ---1 

Calculated Field 

To be Completed by Applicant 

Detailed Budget and Narrative Justification