Greengate Consulting
3455 Peachtree Rd NE Suite 500, Atlanta, GA 30326
contact@greengateplans.com
www.greengateplans.com
(404) 602-0012
Customer Details:
Contact Name
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Company Name
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Phone Number
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E-mail
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example@example.com
Business Type
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LLC
LLP
Corporation
S-Corp
Not for Profit
Ownership: Do any 5 or fewer persons or entities control 80% or more of the company?
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Yes
No
Please list them
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Does the same group control 50% or more of any other entities?
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Yes
No
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Was your business subject o a governmental order, proclamation or decree that impacted your business?
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Yes
No
Select all that apply
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Mandated full shutdown
Mandated partial shutdown
Reduced capacity
Reduced hours
Limits on travel/group meetings
Describe
Please provide the following for all members of the controlled group:
Number of full-time staff in 2019* (avg. 30+ hours/week):
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Quarterly Revenue:
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2019*
2020*
2021*
Q1
Q2
Q3
Q4
Government Action:
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Dates Impacted (Start/End)
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