Qualify - Incentive Claimer - 90 Second Qualification Form

Basic Business Information

Basic Purpose of Business (check all that apply)*

Provide a Service
Sell a Physical Product
Manufacture or Assemble a Product
Other

# of Employees/Staff*

What type of company is it?*

Did this business pay Taxes in any of the past 4 years?*

Yes
No
I don't know

Result of Preliminary Qualification Analysis

YES! There is a VERY strong chance that your company qualifies for unclaimed incentives! Be sure to click the Submit button below so we can get to work recovering your money!

Since your business did not pay taxes in the past 4 years, it is unlikely that we can recover a significant amount of money for you. However, go ahead and click the Submit button below so we can review your information in more detail and perhaps find less traditional incentives for you. We review over 7,00 possible incentives AND we offer additional services that can help you in other ways.

Based on the information you have entered, it is POSSIBLE that we can recover money for you. We just need to review your details and get in touch with you to gather some additional information. Please click the Submit button below so we can review in more detail.

Contact Information

Name*

First Last

Email*

Enter Email Confirm Email

Phone

Company Name*

Company Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Website

Brief description of what the business does

How did you hear about Incentive Claimer?