First Name

Last Name

Phone (numbers only)

Company

Email

How many full-time employees did you have during tax year 2019?

Did your company fully or partially suspend operations during any calendar quarter because of governmental orders limiting commerce, travel, or group meetings due to COVID-19? Yes No

Did you have a significant drop in gross receipts in 2020 compared to 2019? Yes No

Do you expect to have a significant drop in gross receipts in 2021 compared to 2020? Yes No