Verification of No Change in Ownership, Disadvantaged Status or Structure
Affidavit to verify there have been no changes in the circumstances of your firm which affect its ability to meet the size, disadvantaged status, ownership or control requirements of the program. If there have been such changes, please refer to the New Certification application.
If the personal net worth of the majority owner(s) of the firm exceeds $1.32M, as defined by 49 C.F.R. Parts 23 and 26, the firm is not eligible for the DBE or ACDBE certification. If the personal net worth of the majority owner(s) exceeds the $1.32M cap at any time after your firm is certified, the firm is no longer eligible for certification. Should that occur, it is your responsibility to contact your certifying agency, in writing, to advise that your firm no longer qualifies as a DBE or ACDBE.
|MS Word (fill-in form)||Adobe Acrobat (PDF)|
|Verification of No Change - Non-Concessions Firms|
|Verification of No Change - Concessions Firms|
|Personal Financial Statement (upon request)||only available|
in PDF --->
|Expansion of Business Services Request Form|
Use this form if you need to expand the list of services for which your certification can be used to fulfill DBE goals.