Nyc Doing Business Data Form – Fill Out and Use This PDF

To be completed by the City agency prior to distribution: Agency and Transaction ID. Check One Transaction Type (check one).

Under Entity Information, enter the Entity EIN/TIN and the Entity Name.

Entity is a Non-Profit: Yes or No.

Under Entity Type, check Corporation (any type), Joint Venture, LLC, Partnership (any type), Sole Proprietor or Other (specify).

Enter the Address, City, State, Zip, Phone and E-mail.

Filing Status (Select One): Entity has never completed a Doing Business Data Form. Fill out the entire form.

Data Forms submitted now must include the listing of organizations, as well as individuals, with 10% or more ownership of the entity. Until such certification of ownership is submitted through a change, new or update form, a no change form will not be accepted.

Change from previous Data Form dated: Fill out only those sections that have changed, and indicate the name of the persons who no longer hold positions with the entity.

No Change from previous Data Form dated: Skip to the bottom of the last page.

Principal Officers: please fill in the required identification information for each officer. If the entity has no such officer or its equivalent, please check "This position does not exist." If the entity is filing a Change Form and the person listed is replacing someone who was previously disclosed, please check "This person replaced..." and fill in the name of the person being replaced so his/her name can be removed from the Doing Business Database, and indicate the date that the change became effective.

Chief Executive Officer (CEO) or equivalent officer, with This position does not exist: the highest ranking officer or manager, such as the President, Executive Director, Sole Proprietor or Chairperson of the Board.

Chief Financial Officer (CFO) or equivalent officer, with This position does not exist: the highest ranking financial officer, such as the Treasurer, Comptroller, Financial Director or VP for Finance.

Chief Operating Officer (COO) or equivalent officer, with This position does not exist: the highest ranking operational officer, such as the Chief Planning Officer, Director of Operations or VP for Operations.

For each officer, enter First Name, MI, Last and Birth Date (mm/dd/yy), then Office Title, Employer (if not employed by entity) and Home Address.

Principal Owners: fill in the required identification information for all individuals or organizations that, through stock shares, partnership agreements or other means, own or control 10% or more of the entity.

If the entity is owned by other companies that control 10% or more of the entity, those companies must be listed.

If no individual or organization owners exist, check the appropriate box to indicate why and skip to the Senior Managers section. There are no owners listed because (select one): The entity is not-for-profit; The entity is an individual; No individual or organization owns 10% or more of the entity; Other (explain).

If an owner was identified on the previous page, fill in his/her name and write "See above."

Under Individual Owners (who own or control 10% or more of the entity), enter First Name, MI, Last, Birth Date (mm/dd/yy), Office Title, Employer (if not employed by entity) and Home Address.

Under Organization Owners (that own or control 10% or more of the entity), enter the Organization Name.

If the entity is filing a Change Form, list any individuals or organizations that are no longer owners at the bottom of this section, with Name and Removal Date.

Senior Managers: fill in the required identification information for all senior managers who oversee any of the entity's affordable housing transactions with the City.

Senior managers include anyone who, either by title or duties, has substantial discretion and high-level oversight regarding the solicitation, letting or administration of any affordable housing transaction with the City.

At least one senior manager must be listed, or the Data Form will be considered incomplete.

If a senior manager has been identified on a previous page, fill in his/her name and write "See above."

If the entity is filing a Change Form, list individuals who are no longer senior managers at the bottom of this section, with Name and removal date.

By signing, you certify that the information submitted on these two pages and additional pages is accurate and complete.

I understand that willful or fraudulent submission of a materially false statement may result in the entity being found non-responsible and therefore denied future City awards.

Enter Name, Title, Entity Name, Work Phone # and Date, and sign on the Signature line.

Please return this form to the City agency that supplied it to you, not to the Doing Business Accountability Project.

If you have already submitted a DBDF for one transaction type (such as a contract), and this is the first time you are completing a DBDF for an affordable housing transaction, please select the Change option and complete Section 4 (Senior Managers).

An organization is required to submit a DBDF each time it enters into a transaction considered a business dealing with the City.

However, the DBDF has both a Change option, which requires only information that has changed since the last DBDF was filed, and a No Change option.