HIREtech - Disaster Relief Credits

HIREtech

Disaster Relief Credit

Questionnaire

First Name

Last Name

Title

Company Name

Zip Code

Phone Number

Extension

Email Address

When is your company planning to file its taxes this year? (e.g., on time or extending)?

Do you have any additional notes or comments?

Enter information regarding your disaster entry below.

Select state.

How many business locations were affected by the disaster? *
Examples:
* The business location was closed due to voluntary or mandatory evacuation
* The surrounding streets were flooded and employees or customers could not access the business location
* The surrounding streets were impassable due to debris and employees or customers could not access the business location
* The business location flooded
* Any other situation where the business location could not perform significant operations due to the disaster

What dates were the location/s affected: (Please Select or Enter Date. Start Date must be on or after the first date for this disaster, noted above)

Start Date

End Date

Approximately how many total employees were paid wages while their location was affected, regardless of whether they worked? Please include any employee who was placed in another location due to their original location being closed. *
Examples:
* Paid for working at a different location, including working from home
* Paid but did not work (such as salaried employees)
* Paid for working at this location
* The employee took vacation or paid time off

Add Additional Disaster Entry

Select state.

How many locations were affected by the disaster?

What dates were the location/s affected: (Please Select or Enter Date. Start Date must be on or after the first date for this disaster, noted above)

Start Date

End Date

Add Additional Disaster Entry

Select state.

How many locations were affected by the disaster?

What dates were the location/s affected: (Please Select or Enter Date. Start Date must be on or after the first date for this disaster, noted above)

Start Date

End Date

Add Additional Disaster Entry

Select state.

How many locations were affected by the disaster?

What dates were the location/s affected: (Please Select or Enter Date. Start Date must be on or after the first date for this disaster, noted above)

Start Date

End Date

Add Additional Disaster Entry

Select state.

How many locations were affected by the disaster?

What dates were the location/s affected: (Please Select or Enter Date. Start Date must be on or after the first date for this disaster, noted above)

Start Date

End Date

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