Rental Assistance Interest Form

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Please correct the field(s) marked in red below:

Name
 *
Business Name
 *
Telephone Number
 *
Email Address
 *

QUESTIONS

Please answer the questions below to help determine if this program is a proper fit for your business.

1. Based on your most recently filed annual federal tax return, what were the gross receipts of your business?
 *
2. How many employees do you have?
 *
3. What is your home address?
 *
4. What is your business address?
 *
5. What date was your business started?
 *
6. What is your annual personal income?
 *
7. What is the annual income of your lowest paid employee?
 *
8. Is your business a non-profit organization or engaged only in investment real estate?
 *
9. Describe your business including a brief history and the products and/or service(s) your business provides?
 *
10. Explain why you want to participate in the program and how it will help your business grow.
 *

You will be contacted to let you know how to proceed.

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