R357-22-104. Form and Content of Application for Rural Employment Expansion Program Participation

  (1) The content of the application for a rural employment expansion grant shall, at minimum, include the business entity's:

  (a) name;

  (b) physical operating address;

  (c) telephone number;

  (d) email address;

  (e) Federal EIN number;

  (f) primary NAICS code;

  (g) vendor number, if the applicant is a registered vendor with the State of Utah;

  (h) requested rural employment expansion grant amount; and

  (i) forecasted:

  (i) number of new full-time positions;

  (ii) wage of new full-time employee positions; and

  (iii) hire date of new full-time employee positions.

  (2) The following documents shall, at minimum, be included in each application for participation in the program:

  (a) copy of current W-9 form;

  (b)(i) two most recent Form 33H - Utah Employer Quarterly Wage List and Contribution Reports; or

  (ii) a copy of an executed professional employee agreement, as defined in Subsection 31A-40-102(15); and

  (c) employee report covering the twelve months prior to application.