New DBE Personal New Worth (PNW) Statement

About this document

This document is used by all participants in the U.S. Department of Transportation’s Disadvantaged Business Enterprise (DBE) program. Each individual owner of a firm applying to participate as a DBE or ACDBE, whose ownership and control are relied upon for DBE certification must complete this form. Each person signing this form authorizes the Unified Certification Program (UCP) recipient to make inquiries as necessary to verify the accuracy of the statements made. The agency you apply to will use the information provided to determine whether the owner is economically disadvantaged as defined in DBE program regulations 49 C.F.R. Parts 23 and 26. Return to appropriate UCP certifying member, not U.S. DOT.

The U.S Department of Transportation does not review DBE applications. If you have questions about where to send your DBE application package, please contact the state transportation agency in the state in which you want to apply for. For your reference, we maintain a list of DBE program points of contacts and websites.