STEO Client Report Form

OMB Control Number: 3245-XXXX

Expiration Date: XX/XX/XXX

Client Report STEP Year X (FY 20XX Award)

# (1)

State (2)

STEP Client Business Name (3)

Indicate NTE or ME(4)

New STEP Client (5)

Primary NAICS Code AND Industry (6)

Export Markets Supported by STEP Program (7)

Freq of STEP Client (8)

Social & Econ (9)

Women (10)

Vet (11)

D`abled Vet (12)

Rural (13)

Not disadvantaged (14)

Jobs Created PLUS Retained (15)

TOTAL

0

0

0

0

0

0

0

0

1) Add name of each client (ESBC) that has been provided assistance with STEP Federal funds. 2) Indicate if STEP Client is new to export (NTE) or market expansion (ME). 3) Specify if there is a new STEP Client (first time STEP participant). 4) Add the ESBC's primary NAICS code and industry. 5) Include all export markets supported by STEP for each Client. 6) Add the total ‘number’ of times each STEP Client participated in an export activity using STEP Federal funds (frequency). 7) Place an "X" for each attribute that applies to each STEP Client (ESBC). Add more rows as needed. Update and submit with your quarterly reporting. Do not alter format form.

ESBCs that receive STEP funds: 8) Frequency is defined as the number of times the STEP Client (ESBC) participated in an export activity using STEP Federal grant funds. 9) Owned and controlled by socially and economically disadvantaged individuals. 10) Owned and controlled by women. 11) Owned and control by veterans. 12) Owned and controlled by service-connected disabled veterans. 13) Owned and controlled in rural area. 14) Not disadvantaged (does not represent any of the groups 2-6). 15) Jobs Created PLUS Jobs Retained – Insert the total ‘number’ of jobs created PLUS retained by the ESBC named on the line. For the purposes of STEP, jobs created/retained is defined as the sum of all employment gains from an ESBC expanding its establishment as a result of engaging in a STEP supported activity occurring during this 2 year award performance period. If your state has a different methodology for obtaining this information, please express this to your assigned Program Manager for approval (and our records) on how you derived at the reported number.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information (such as this survey) unless it displays a valid OMB control number. The control number for this information collection is 3245-XXXX and expires MM/DD/YYYY. Please return the completed form to your STEP program manager. This information will be used to produce reports on the STEP program. The total time required for to complete this form is estimated at 60 minutes. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to U.S. Small Business Administration, Director, Records Management Division, 409 3rd St., S.W., Washington, DC 20416 and Desk Officer for the Small Business Administration, Office of Management and Budget, New Executive Building, Room 10202, Washington, DC 20503.