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EXHIBIT B: Interview Form - Non Residential <br />Project Name: _ <br />Name of Business, <br />Business Address: <br />Contact Person: <br />Phone Number: <br />Mailing Address: _ <br />Funding Source <br />Alternate Phone Number: <br />Type of Business: ❑ Corporation ❑ Sole Proprietorship ❑ Partnership ❑ Nonprofit <br />Primary Language: <br />Own site Lease site <br />Monthly Payment: <br />Other businesses under same entity: <br />Description of Business Operation: <br />Number of Employees: <br />Gross Sales: $ Net Income: $ <br />Lease Term & Options: <br />Deposit: <br />Move In Date: <br />Employees with Disabilities Requiring Accommodations at Replacement Site Y / N <br />255D128 <br />