STORE Capital Coronavirus Questionnaire Question Title * 1. Contact Name Question Title * 2. Company Name Question Title * 3. What industry does your business operate in? (please provide NAICS code if available) Question Title * 4. Please describe the impact of Coronavirus on your business. Highly Negative Neutral Highly Positive Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 5. What is the current status of your business? Open Partially Open - limited services Closed Question Title * 6. How many employees did you have prior to March 1, 2020? 0-50 50-100 100-250 250-500 over 500 Question Title * 7. How many employees do you currently have or expect to have in the next 30 days? 0-50 50-100 100-250 250-500 over 500 Question Title * 8. Have you been in contact with a lender to get access to capital made available through the CARES Act? Yes No We are considering contacting a lender for more info, but have not yet. Question Title * 9. If you have contacted a lender or may do so, do you have a pre-existing relationship with that lender? Yes No Question Title * 10. Do you believe you will qualify for the Paycheck Protection Program? Yes No Not sure Already qualified for the Paycheck Protection Program Question Title * 11. Please explain why you believe or do not believe you will qualify for the Paycheck Protection Program. Question Title * 12. Do you believe you will qualify for capital made available through any other portion of the CARES Act? Likely Not sure Unlikely Question Title * 13. Would you like someone from STORE Capital to contact you and see if we can help? Yes No Question Title * 14. Please provide a preferred phone number and time to contact you. Done
