ERTC simple qualify

1

Please enter your first and last name* This field is required.

2

Enter your email address* This field is required.

3

Enter your phone number* This field is required.With Area Code

8015551234

4

Enter your Company name* This field is required.Company name

5

Enter your company name* This field is required.

6

Enter your city

7

Enter your state* This field is required.

8

Who referred you to ERTC Simple?* This field is required.Please select

9

If other please specified who referred you:

10

Did you have W2 employees in 2020 or 2021? * This field is required.

YESNO

11

Are you the sole owner of the company?

YESNO

12

Do you have partners? If so, what percentage of the company do you own?

13

What is the role with your company:

14

How many employees did you have in 2020 - 2021?

15

Did you experience a partial or complete government-mandated shutdown anytime between 3/13/2020 - 9/30/21?* This field is required.

YESNO

16

Were your gross receipts (total deposits) for at least one quarter in 2020 less than 50% of your gross receipts for the same quarter in 2019?* This field is required.

YESNO

17

Were your gross receipts (total deposits) for at least one quarter in 2021 less than 20% of your gross receipts for the same quarter in 2019?* This field is required.

YESNO

18

Were you affected by a supply chain disruption that affected more than 10% of your business?* This field is required.

YESNO