COVID19 Wabash County Long-Term Recovery Grant: Employee Income Survey Form

Employers need to submit a survey below for every employee (including the owner if considered an employee) retained at the time of this application. This is required for OCRA's Community Development Block Grant program as we need to serve 51% or more jobs that are held by low to moderate income (LMI) persons.
Example write "OC" in the blank for an employee named Oliver Conner.
Example Cashier, Server, Seamstress, etc.
Example: $12,500