| 1 | (a) Is this business currently trading? |
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| | ☐ Yes [Go to Q2] |
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| | ☐ No [Go to Q1b] |
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| | (b) Is the halt in business trading a result of COVID-19? |
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| | ☐ Yes [Go to Q2] |
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| | ☐ No [Go to comments] |
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| 2 | Does this business employ any staff? |
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| | [NOTE: This includes all employees on the books and not currently working] |
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| | ☐ Yes |
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| | ☐ No |
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| | [NOTE: Businesses are not required to check records for the following questions] |
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| 3 | (a) Over the past month, has revenue increased, decreased or stayed the same? |
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| | [NOTE: Revenue refers to income generated from the sale of goods or services] |
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| | ☐ Increased |
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| | ☐ Decreased |
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| | ☐ Stayed the same |
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| | ☐ Don't know |
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| | (b) And over the next month, do you expect revenue will increase, decrease or stay the same? |
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| | [NOTE: Revenue refers to income generated from the sale of goods or services] |
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| | ☐ Increase |
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| | ☐ Decrease |
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| | ☐ Stay the same |
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| | ☐ Don't know |
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| | (c) Over the past month, have operating expenses increased, decreased or stayed the same? |
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| | [NOTE: Operating expenses refers to expenses incurred in undertaking normal business operating activities. Examples include payroll, rent, inventory cost, marketing and insurance] |
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| | ☐ Increased |
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| | ☐ Decreased |
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| | ☐ Stayed the same |
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| | ☐ Don't know |
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| | (d) And over the next month, do you expect operating expenses will increase, decrease or stay the same? |
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| | [NOTE: Operating expenses refers to expenses incurred in undertaking normal business operating activities. Examples include payroll, rent, inventory cost, marketing and insurance] |
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| | ☐ Increase |
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| | ☐ Decrease |
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| | ☐ Stay the same |
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| | ☐ Don't know |
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| | (e) Over the past month, have the number of employees increased, decreased or stayed the same? |
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| | ☐ Increased |
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| | ☐ Decreased |
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| | ☐ Stayed the same |
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| | ☐ Don't know |
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| | (f) And over the next month, do you expect the number of employees will increase, decrease or stay the same? |
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| | ☐ Increase |
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| | ☐ Decrease |
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| | ☐ Stay the same |
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| | ☐ Don't know |
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| 4 | (a) Over the past 3 months, has the business sought additional funds for any purpose? |
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| | [NOTE: Includes funds sought from banks or other financial institutions, owners’ personal line of credit or savings (e.g. redraw facility on an existing loan), owners’ family or friends, and other businesses] |
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| | ☐ Yes [Go to Q4b] |
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| | ☐ No [Go to Q4c] |
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| | ☐ Don't know [Go to Q5 (ONLY if business also selected ‘Yes’ at Q2)] |
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| | (b) You indicated the business has sought additional funds over the past 3 months. Was the business successful in obtaining additional funds? |
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| | [NOTE: It is possible for businesses to have multiple applications for additional funds that are at different stages of completion. Multiple responses can be selected where this is the case] |
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| | ☐ Yes [Go to Q5 (ONLY if business also selected ‘Yes’ at Q2)] |
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| | ☐ Application still in progress [Go to Q5 (ONLY if business also selected ‘Yes’ at Q2)] |
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| | ☐ No [Go to Q5 (ONLY if business also selected ‘Yes’ at Q2)] |
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| | ☐ Don’t know [Go to Q5 (ONLY if business also selected ‘Yes’ at Q2)] |
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| | (c) You indicated the business has not sought additional funds for any purpose. Is this because the business…? |
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| | [NOTE: This question is about the reasons for not seeking additional funds. I am going to read out some options, please answer with ‘yes’, ‘no’ or ‘don’t know’ for each] |
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| | ☐ Had sufficient funds |
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| | ☐ Had no requirements for capital expenditure or other investments |
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| | ☐ Is unwilling to increase debt |
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| | ☐ Could not meet debt repayments |
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| | ☐ Is unable to meet eligibility requirements |
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| | ☐ Are there any other reasons the business has not sought additional funds for any purpose? (please specify) |
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| | NOTE: Questions 5 and 6 are to be answered by employing businesses only (i.e. those that selected 'Yes' to Question 2). Those responding ‘No’ to Question 2 go to Question 7 |
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| 5 | (a) Based on current operations, does the business have a sufficient number of employees? |
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| | ☐ Yes |
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| | ☐ No |
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| | ☐ Don’t know |
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| 6 | (a) Are any of your existing employees currently unavailable due to factors related to COVID-19? |
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| | [NOTE: Factors might include staff that have/think they have COVID-19, staff that are a close contact and isolating, or staff that don’t want to come into work for fear of contracting COVID-19] |
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| | ☐ Yes [Go to Q6b] |
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| | ☐ No [Go to Q7a] |
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| | ☐ Don’t know [Go to Q7a] |
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| | b) You indicated that availability of employees is affected by factors related to COVID-19. Are any of the following reasons affecting employee availability? (select all that apply) |
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| | ☐ Staff have COVID 19 symptoms or illness |
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| | ☐ Self isolation or quarantine requirements |
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| | ☐ Pending COVID-19 test results |
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| | ☐ Caring responsibilities (For example: caring for others who are unwell or caring for children due to school or daycare closures) |
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| | ☐ Staff have indicated an unwillingness to work due to concerns over catching COVID |
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| | ☐ Any other reasons (please specify) |
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| | (c) You indicated that availability of workers is affected by COVID-19. What proportion of your workforce are currently impacted by COVID-19 and unable to work? |
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| | ☐ Less than 25 per cent |
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| | ☐ 25 to less than 50 per cent |
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| | ☐ 50 to less than 75 per cent |
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| | ☐ 75 to 100 per cent |
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| | ☐ Don’t know |
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| | (d) Thinking of your workforce currently unable to work due to being impacted by COVID-19, are you able to cover the hours using existing employees? |
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| | ☐ No |
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| | ☐ Yes, existing staff can cover a small amount (some) of the hours |
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| | ☐ Yes, existing staff can cover most of the hours |
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| | ☐ Yes, existing staff can cover all the hours |
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| | ☐ Don’t know |
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| 7 | (a) Is the business currently experiencing any supply chain disruptions? A supply chain is a logistics network between a business and its suppliers to produce and distribute a product to the customer. A supply chain disruption is an interruption to that network. |
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| | ☐ Yes [Go to Q7b] |
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| | ☐ No [Go to Comments] |
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| | ☐ Don't know [Go to comments] |
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| | (b) You indicated the business is currently experiencing supply chain disruptions. To what extent are the supply chain disruptions affecting this business? (select one option only) |
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| | ☐ Not at all |
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| | ☐ A small extent (e.g. some delays but little impact on revenue) |
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| | ☐ A great extent (e.g. major delays/cannot obtain certain items and significant impact on revenue) |
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| | ☐ Don’t know |
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| | (c) Have any of the following factors impacted this business’ supply chain? |
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| | ☐ Existing suppliers unable to provide products (supply constraints) |
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| | ☐ Unable to source or substitute alternate suppliers for products |
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| | ☐ Increased prices (including cost of transport) |
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| | ☐ Increased time to receive products from suppliers (i.e.. domestic and international delivery delays) |
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| | ☐ Any other factors? |
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