Shopping Center Name or Landlord’s Site Number
*
Full Legal Name of Tenant Business
*
Have you applied for any other relief under the CARES Act?
*
Yes
No
Do you have more than 500 employees?
*
Yes
No
Name of Bank with which you have a banking relationship
*
Name of Tenant Authorized Representative
*
Tenant Mailing Address:
Street Address and Suite Number
*
City
*
State
*
Zip Code
*
Tenant Email Address
*
Tenant Phone Number
*
Type of Small Business Administration Loan You Wish to Apply For
*
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I acknowledge and understand that the submission of this form is only a request for assistance and that no attorney-client relationship is created. Your request will not be acted on until you have signed a separate engagement letter from Fennemore Craig, P.C..
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