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We will complete a short qualification survey once completed we will schedule a time for you to speak with a Licensed CPA to go over your claim eligibility and credit calculation.

How many on average non-owner, non-family member W2 Employees did you have in:

2019*

2020*

2021*

Your Information:

First Name*

Last Name*

Email*

Cell Phone*

Office Phone

Customer Representative Name if Applicable

Let’s review your Company Information – We use your physical address and industry to review the thousands of government mandates issued federally as well as local government mandates for qualification purposes prior to meeting with you.

Legal Company Name*

Company Industry*

Company Address*

Company City*

Company State*

Company Zip code*

Business Start Date

Ownership Structure

Number of Owners (Married Couples Count as 1)

Does any individual own 51% or more of this business?* Yes No

Type of entity 1040 Schedule C 1065 Partnership S-Corp C-Corp and Non Profit

Tax Basis of Accounting Cash Accrual Modified Cash

Other Businesses owned (list all businesses owned by same owners of this business)

Essential or Non-Essential Business Essential Non-Essential

Did your business shut down? Yes No

From

Did you get PPP?

2020 Yes No

2021 Yes No

Did your company pay for employee Healthcare expenses or insurances? Healthcare 401k Other None

Where do you want your refund check Sent?

Describe how COVID has negatively impacted the business or changed how it operates since 2019. Be as descriptive as possible. For 2020 and 2021?

Did the business use a PEO (Professional Employer Organization or Employee Leasing Company) as a payroll provider in 2020 or 2021?* Yes No