Congressman Emanuel Cleaver, II is conducting a survey of businesses in the 5th Congressional District affected by tariffs. If interested, please fill out the form below. * indicates information that you need to provide. Name of business: * Name of contact individual: * Phone Number * Phone Type: Standard voice telephoneVideophone [VP]Text-telephone device [TTD] Contact Information Street Address: * Street Address Continued: City: * State: * Zip Code: * Email: * Business Information Is your Business? * Please Select oneSmall (under 500 employees)Medium (500 - 1,000 employees)Large (over 1,000 employees) What is your field of industry? (construction, farming, manufacturing, etc.): Are you currently experiencing revenue impacts from the tariffs or do you anticipate impacts to your company? If so, how? * Do you believe that the tariffs on trade will have a negative or positive impact on jobs at your business and why? * Is your business dependent upon an imported commodity or product? If so, please describe. * Does your business export products directly or rely on export markets? If so, please describe. * Do you have any additional comments or information regarding the tariffs and the dependence of your business on international trade that you would like to share with the Congressman? * CAPTCHA
