Hi-CAP Invest is an offering within the Hi-CAP program and is meant for venture capital funds and investors.


INSTRUCTIONS

This form contains the following:

Part I - Request for Information (RFI) application

Part II - Technical Proposal Qualifier (TPQ) application
Section I: Eligibility Checklist
Section II: Sex Offender Investor Certification

Upon completion of Parts I and II, the applicant will be directed to the final page requesting for an e-signature for the Sex Offender Investor Certification. Please note that the undersigned should be an authorized representative of the investor.

You may save and return to this application to complete it at any point.

Email hicap@htdc.org with queries regarding the application process.

PRIVACY NOTICE

Selected information from this application will be shared with the U.S. Department of the Treasury ("Treasury"). Treasury has published a Privacy and Civil Liberties Impact Assessment that describes what Treasury will do with the information your business provides in this application. It can be found on the Treasury website.

If you have any questions about this document, please email Privacy@Treasury.gov. 

SECTION I

For any “No” responses, please provide comments in the “Comments” box.

This certification is required by Section 3011(c)(2) of the Small Business Jobs Act of 2010 from any private entity that receives a loan, a loan guarantee, or other financial assistance using funds received by a participating State under the State Small Business Credit Initiative. Under the State Small Business Credit Initiative (SSBCI), investors and investees must certify that their principals have not been convicted of a sex offense against a minor.

The investor hereby certifies the following to the participating jurisdiction: No principal of the entity listed above, has been convicted of a sex offense against a minor (as such terms are defined in 34 U.S.C. § 20911). For the purposes of this certification, “principal” is defined as if a sole proprietorship, the proprietor; if a partnership, each managing partner and each partner who is a natural person and holds 50 percent or more ownership interest of any class of the partnership interests; if a corporation, limited liability company, association, development company, or other entity, each director, each of the five most highly compensated executives or officers of the entity, and each natural person who is a direct or indirect holder of 50 percent or more of any class of equity interest in the entity; and if a partnership where the managing partner is a corporation, limited liability company, association, development company, or other entity, each director and each of the five most highly compensated executives or officers of the entity.

MAHALO!

We appreciate you taking the time to complete this application for Hi-CAP Invest.

Upon clicking the "Submit" button, you will be directed to the final page requesting for an e-signature for the Sex Offender Investor Certification. Please note that the undersigned should be an authorized representative of the investor.

You should be receiving a confirmation email upon successful submission of this application.
Please check your spam folder if you did not receive it in your inbox.

Email hicap@htdc.org with queries regarding the application process.