QSBSRollover.com form

1
Which of the following describes your situation?* This field is required.
I recently sold QSBS
I'm thinking of selling QSBS
I have a sale of QSBS in progress
I don't have Qualified Small Business Stock, or don't know
2
When was your QSBS sale finalized?* This field is required.
Date
Month
Day
Year
3
When will your QSBS sale be finalized?* This field is required.
Date
Year
Month
Day
4
Check all that apply to your QSBS situation:* This field is required.
I held my stock for less than 5 years
I held my stock for more than 5 years
I had basis in my stock (typically from a direct investment of capital)
My gain (sale value minus basis) is less than $10M
My gain (sale value minus basis) is more than $10M
The underlying business (within last 5 years) converted to a C Corp
I am a founder or employee of the business I sold stock in
I am an outside investor or advisor for the business I sold stock in
I sold my stock on the public market
I invested in my stock as an "angel" or direct investor
I invested in my stock through a venture fund
This is my first significant stock sale
I currently work with a tax advisor or tax attorney
5
In what timeframe would you like to sell your QSBS?* This field is required.
This year
Next year
Within the next 2-5 years
More than 5 years from now
6
What was your total gain amount?
7
Your Name* This field is required.
First Name
Last Name
8
Your Email* This field is required.
example@example.com
9
Phone Number* This field is required.
Please enter a valid phone number.
10
How did you hear about QSBSRollover.com?
Web Search
Direct Referral
Email
In-person event or webinar
I don't remember
11
Is there anything else you'd like to tell us about your situation?
Huge
Large
Normal
Small
Ok
Ok
12
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