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Covid-19 Relief Program
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COVID-19 Relief Program
Are you a consumer or business customer in need?
Business
Consumer
COVID 19 Relief Program - Business
First Name
Last Name
Email Address
Phone Number
Relief Desired
Payment Deferral
Fee Refund
Other
Brief explanation of relief desired above
Brief explanation of what adverse economic effects COVID-19 has had/is having on your business
When did the impact start?
What is the estimated end date of impacts?
What are your business' revenues during the COVID-19 outbreak time period?
What were your business' revenues during the SAME period of the prior year?
Amount of business interruption insurance received or anticipated, if any?
How many employees did you employ prior to the COVID-19 outbreak?
How many employees do you employ at this time? (during the COVID-19 outbreak)?
COVID-19 Relief Program - Consumer
First Name
Last Name
Email Address
Phone Number
Relief Desired
Payment Deferral
Fee Refund
Other
Brief explanation of relief desired above.
Brief explanation of what adverse economic effects COVID-19 has had/is having on you or your family.
