Small Business Tell Your Story

Business Name

First Name

Last Name

Type of Business Salon
Gym
Accounting Firm
Auto Repair
Boutique
Medical
Other (Specify Below)

If you answered 'Other' above, please specify the Business Type here:

Business Address

Street 1 Street 2 City State Zip

Email Address*

Business Phone () -

Website or Social Media

How would your business be impacted if the proposed service tax becomes law? (Please describe specific impacts on costs, customers, jobs, or operations.)

How many employees do you have, and how might they be affected?

What would this tax mean for your customers or the community you serve?

Do you have a personal message you’d like to share with lawmakers about this tax?

Would you be willing to speak publicly, provide a quote for use in materials, or participate in an event? Yes
No

Do you have a photo of your business or team you’d like to share? If so, can you forward it to CFuchs@sgop.ilga.gov

YesNo

Anything else you’d like us to know?

I give permission for my story to be used in advocacy efforts (including social media, printed materials, testimony, or press releases) Yes
No

Would you like to receive email updates from Senator Rose?

YesNo