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What is the primary industry or line of business at this location? That is, what is the principal product or service at this location?
   
   
 
Does (Company Name) have more than one location in the United States?
 
Yes
 
No
 
Do not know
   
 
If you answered yes, what is the approximate total number of employees (Company Name) has at all the locations in the United States?
 
1 - 49
 
50 - 999
 
1,000 - 4,999
 
5,000 or more
   
 
What is the total number of permanent employees in your company at this mailing address?
 
1 - 19
 
20 - 49
 
50 - 99
 
100 - 249
 
250 -499
 
500 - 999
 
1,000 - 2,500
 
Over 2,500


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Name:

Phone:


Email Address:


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