SBA Form 1010-AIT 8(A) Business Development (Bd) Program Application American Indian - Tribally-Owned Concern

What Is SBA Form 1010-AIT?

SBA Form 1010-AIT, 8(a) Business Development (BD) Program Application American Indian - Tribally-Owned Concern is a form completed by American Indian Tribes that owns 51% or more of a small business applying for the 8(a) Business Development Program.

The latest edition of the form was released by the Small Business Administration (SBA) in March 2011. An up-to-date SBA Form 1010-AIT fillable version is available for download and digital filing below or can be found on the SBA forms website.

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Approval No. OMB 3245-0331
Expiration Date: 02/29/2020
American Indian Tribe Information
The American Indian Tribe that owns at least 51 percent of the applicant business
concern
must complete this form. 13 C.F.R. § 124.109(b).
YOUR SIGNATURE ON THIS FORM INDICATES THAT YOU FULLY UNDERSTAND
ALL QUESTIONS AND CERTIFIES THAT ALL RESPONSES AND DOCUMENTS ARE
TRUTHFUL AND ACCURATE. Please submit this form with the 8(a) Business
Development Program Application – SBA Form 1010. The information will be used as
part of the program eligibility determination.
Name of Applicant Business Concern (include any trade or d.b.a. names):
_________________________________________________________________________
Name of American Indian Tribe (AIT): _________________________________________
Note: AIT means any Indian tribe, band, nation, or other organized group or community of
Indians, which is recognized as eligible for the special programs and services provided by the
United States to Indians because of their status as Indians, or is recognized as such by the State
in which the tribe, band, nation, group, or community resides. 13 C.F.R. § 124.3.
Telephone: (
)____________________
Fax: (
)_________________________
Address:
_______________________________________________________________________
City: _____________________ County: _____________ State: ______________ Zip:
______________
E-mail: _____________________________ @ ______________
Mailing Address (if different from above)
Address:
_____________________________________________________________________
City: _____________________ State: ______________ Zip: ______________
Indian Tribe percent ownership of applicant business concern: ___________
Please answer the following questions and provide the required documents:
1. Has the Tribe previously established its economic disadvantaged status
[ ]Yes
[ ]No
under the 8(a) BD Program? If yes, provide a copy of the SBA
determination. If no, provide the following information for the tribe:
The number of tribal members.
The present tribal unemployment rate.
The per capita income of tribal members, excluding judgment
Approval No. OMB 3245-0331
Expiration Date: 02/29/2020
American Indian Tribe Information
The American Indian Tribe that owns at least 51 percent of the applicant business
concern
must complete this form. 13 C.F.R. § 124.109(b).
YOUR SIGNATURE ON THIS FORM INDICATES THAT YOU FULLY UNDERSTAND
ALL QUESTIONS AND CERTIFIES THAT ALL RESPONSES AND DOCUMENTS ARE
TRUTHFUL AND ACCURATE. Please submit this form with the 8(a) Business
Development Program Application – SBA Form 1010. The information will be used as
part of the program eligibility determination.
Name of Applicant Business Concern (include any trade or d.b.a. names):
_________________________________________________________________________
Name of American Indian Tribe (AIT): _________________________________________
Note: AIT means any Indian tribe, band, nation, or other organized group or community of
Indians, which is recognized as eligible for the special programs and services provided by the
United States to Indians because of their status as Indians, or is recognized as such by the State
in which the tribe, band, nation, group, or community resides. 13 C.F.R. § 124.3.
Telephone: (
)____________________
Fax: (
)_________________________
Address:
_______________________________________________________________________
City: _____________________ County: _____________ State: ______________ Zip:
______________
E-mail: _____________________________ @ ______________
Mailing Address (if different from above)
Address:
_____________________________________________________________________
City: _____________________ State: ______________ Zip: ______________
Indian Tribe percent ownership of applicant business concern: ___________
Please answer the following questions and provide the required documents:
1. Has the Tribe previously established its economic disadvantaged status
[ ]Yes
[ ]No
under the 8(a) BD Program? If yes, provide a copy of the SBA
determination. If no, provide the following information for the tribe:
The number of tribal members.
The present tribal unemployment rate.
The per capita income of tribal members, excluding judgment
awards.
The percentage of the local Indian population below the poverty
level.
The tribe’s access to capital markets.
The tribe’s assets as disclosed in the current tribal financial
statement, including those which are encumbered or held in trust;
the status of assets encumbered or in trust must be clearly
delineated.
2. Does the Tribe or subsidiary of the Tribe own 50% or more of another
[ ]Yes
[ ]No
business other than the applicant business ? If yes, identify the names of
any other business concern(s), the primary NAICS code of the other
business concern(s), and which (if any) of the other business concerns
have ever participated in the 8(a) BD Program.
3. Does the Tribe own the applicant concern directly (rather than through a
[ ]Yes
[ ]No
subsidiary)?
[ ]Yes
[ ]No
4. Does the Tribe own the applicant business through a subsidiary? If yes,
provide the name and address of that subsidiary.
[ ]Yes
[ ]No
5. Is a tribal member the highest officer or designated manager of the
applicant business? If yes, provide evidence of tribal membership. If no,
provide a copy of the tribal management development plan.
Please provide the following documents
Evidence of the tribe’s recognition as a tribe eligible for the special programs and services
provided by the United States or by the Tribe’s state of residence.
Documentation showing the AIT’s ownership of the applicant business firm.
Copies of all governing documents, such as the tribe’s constitution or business charter.
Copies of the tribe’s articles of incorporation and bylaws as filed with the organizing or
chartering authority, or similar documents needed to establish and govern a non-corporate
legal entity.
NOTICE OF CRIMINAL PENALTIES AND ADMINISTRATIVE REMEDIES FOR
FALSE STATEMENTS: Under Title 18 U.S.C. § 1001 and Title 15 U.S.C. § 645, any
person who misrepresents a business concern’s status as an 8(a) Program participant, or
makes any other false statement in order to influence the certification process in any way,
or to obtain a contract awarded under the preference programs established pursuant to
section 8(a), 8(d), 9 or 15 of the Small Business Act, or any other provision of Federal Law
that reference Section 8(d) for a definition of program eligibility shall be: (1) Subject to
fines and imprisonment of up to 5 years, or both, as stated in Title 18 U.S.C. § 1001; (2)
subject to fines of up to $500,000 and imprisonment of up to 10 years, or both, as stated in
Title 15 U.S.C. § 645; (3) Subject to civil and administrative remedies, including
suspension and debarment; and (4) Ineligible for participation in programs conducted under
the authority of the Small Business Act.
CERTIFICATIONS: By signing this form, I certify that all information in this
application, including all supporting documents, is true and complete to the best of my
knowledge, and that I understand that SBA is relying on this information in making its
determination of my company’s eligibility for 8(a) BD Program.
Form must be signed by the Tribal Chief.
___________________________
________________________
____________
Signature
Print Name
Date
The estimated burden for completing this form, including reading the instructions and
gathering the information, is 1 hour for initial application and each annual update. (A
submission for reconsideration is estimated to require approximately 30 minutes). You are
not required to respond to any collection of information unless it displays a currently valid
OMB approval number. Comments on the burden should be sent to U.S. Small Business
Administration, Chief, AIB, 409 3rd St., S.W., Washington D.C. 20416, and/or SBA Desk
Officer, Office of Management and Budget, New Executive Office Building, Room 10202,
Washington, D.C. 20503. PLEASE DO NOT SEND FORMS TO OMB.
SBA Form 1010 – AIT (3/11)

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SBA Form 1010-AIT Instructions

The form requires the representative to identify the 8(a) applicant and the American Indian Tribe (AIT) that owns more than a half of the applicant's business. An AIT may be any state-recognized Indian tribe or any tribe, band or nation recognized as eligible for Federal special programs and services because of their status as Indians.

Representatives of the tribe filing the SBA Form 1010-AIT are required to provide the following documentation:

  1. Proof of the tribe's eligibility for Government-provided or State-provided special programs and services.
  2. Evidence of the AIT's ownership of the applicant's business.
  3. The tribe's articles of incorporation and bylaws along with the business charter, constitution or other governing documents.

The completed form must be signed by the Tribal Chief and submitted along with the main SBA 1010 Form.

SBA 1010-AIT Related Publications

  1. SBA Form 1010-ANC, 8(a) Business Development (BD) Program Application Alaskan Native Corporation-Owned Concern is a form filed by representatives of Alaskan Native Corporation-owned business that wish to apply for the 8(a) Business Development Program with the SBA.
  2. SBA Form 1010-NHO, 8(a) Business Development (BD) Program Application Native Hawaiian Organization-Owned Concern is a form completed by representatives of Native Hawaiian Organizations that own the businesses of 8(a) Business Development Program applicants.
  3. SBA Form 1010-IND, 8(a) Business Development (BD) Program Application Individual Information is a form filled out by individuals that own more than 10% of a small business applying for the 8(a) Program.
  4. SBA Form 1010-CDC, 8(a) Business Development (BD) Program Application Community Development Corporation-Owned Concern is a form filed by the Certified Development Company (CDC) that owns the small business of an 8(a) applicant.
  5. SBA Form 1010, Representative Form 1010 Business is a form used by businesses to inform the SBA of the representatives and compensation paid for assistance with their 8(a) initial application.
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