Employer Information

*= Required Field

Employer Qualification: Only an employer may receive a tentative credit reservation for an eligible employee.

*Required Field Entity TypeSelect one

Individual

Estate

Trust

C Corporation

S Corporation

General Partnership

Limited Partnership

Limited Liability Partnership

Limited Liability Company Treated as a Partnership

Limited Liability Company Treated as a Corporation

Exempt Organization with Unrelated Business Income

Date: 10/16/2025