Project Intake Form for Research Tax Credits and other potential credit and incentives Please fill out the form below OWNER INFORMATION / REPORT PREPARED FOR:Entity Name:* Contact Name* First Last Type of Business States Located InAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingType of EntitityC-CorpS-CorpSole ProprietorshipLLCWhat Type of Return for LLCForm 1040, Schedule C, E, or FForm 1120 or Form 1120SForm 1065Form 8832How Many Owners?Year End Calendar Year Fiscal Year Specific Date MM slash DD slash YYYY Annual PayrollNumber of EmployeesDo You Use Outside Contracting for Design/Engineering? Yes No Do You Have Any Patents? Yes No Type of Potential R&D Product Process Software (IUS) W2 BOX 1 WAGESDOC COLLECTION / UPLOAD Drop files here or Select files Max. file size: 50 MB. TAX RETURNS – Corporate and Personal EmailThis field is for validation purposes and should be left unchanged.