California Exporter Verification of Successful Outcome

The California STEP program appreciates your business endeavors and looks forward to a continued successful partnership. Please verify and validate the accuracy of the information below by completing this form. Feel free to include any comments regarding the assistance provided by the California STEP program.

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If you prefer to download the form in PDF, complete and sign it rather than submitting the online questionare (below), please attache the form here.
Part I
Name and Contact of Your Company
Company Name:*
Industry*
Contact Name*

First

Last
Title:*
Address*

Street Address

Address Line 2

City

State

ZIP Code
Phone*
Fax
Email*
Export Experience of Your Firm*

Please indicate your level of export experience
Export Success Details
Company Name:
(Optional)
Industry
Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Assistance Provided*
Date of when assistance was provided:
Name of Event or Activity*
1. Outcome Achieved
1. Date of Outcome
Market (Country or Region) of Export Success
Initial Export Sales Resulting from Activity
Projected Export Sales

The amount of sales expected over the next 12 to 18 months resulting from the activity
2. Outcome Achieved
2. Date of Outcome
Initial Export Sales resulting from participation in STEP Activity
3. Outcome Achieved
3. Date of Outcome
3. Outcome Value (USD)
Projected Export Sales

Export sales expected over the next 12 to 18 months
Jobs Impact*

The effect on creating or retaining jobs, in connection with your export activities, and related to participation in the STEP program
Total U.S. Dollar Value of Outcomes:
$0.00
Part II
Client Verification Statement

The California STEP program provided assistance that helped achieve the following outcome(s):
Verification Signature*
- Check box for signature
“I hereby certify that all the information provided in this document, as well as any accompanying documents, are true and complete.”
Date*
Verification of business or personal information is voluntary. All business or personal information verified will be protected to the extent permitted by the Privacy Act of 1974 and the Freedom of Information Act of 1966. Aggregate data from information verified by companies will be used to report California STEP results to the U.S. Small Business Administration and the public. Please return the signed (check marked) document to California STEP in the cover letter or the eMail address.
Comments
Funded in part through a Grant with the U.S. Small Business Administration.

California Exporter Verification of Successful Outcome

Part I

Name and Contact of Your Company

Export Success Details

Part II

Client Verification Statement

California STEP
State Trade Expansion Program

Resource Partners

CITD

Contact Us

Knowledge Community

California STEP

For Employers

For Workers

For Faculty

For Students

California Exporter Verification of Successful Outcome

Part I

Name and Contact of Your Company

Export Success Details

Part II

Client Verification Statement

California STEP State Trade Expansion Program

Resource Partners

CITD

Contact Us

Knowledge Community

California STEP

For Employers

For Workers

For Faculty

For Students

California STEP
State Trade Expansion Program