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Please fill out the following form prior to your meeting. This helps us ensure accuracy of records and prepare for your meeting.
Returning client?
Yes
No
Returning Clients; If you have had no changes since last year please check here, add your contact details, and sign at the bottom.
Returning Clients; If you have had no changes since last year please check here, add your contact details, and sign at the bottom.
No Changes
Please fill out all Blue sections completely, enter what you can into Purple section, Gray is for internal use only.
Today's Date
*
Referral/Source:
Client Demographics
Contact Info:
Business Name
*
Business Address
*
Business Description
*
Mailing Address
Same as Business Address
Yes
Mailing Address
Type of Business
*
S Corp
LLC
C Corp
Trust
Non-Profit
Please select one
Owner
Name
*
Role
*
Email
*
Phone
*
Primary contact
Same as Above Owner
Yes
Name:
Phone
Email
Role
BOI compliance Information
Business Owners / Share Holder / Executives
Name
Residential Address
DOB
Role
Photo ID on File
Yes
No
Name
Residential Address
DOB
Role
Photo ID on File
Yes
No
Name
Residential Address
DOB
Role
Photo ID on File
Yes
No
Name
Residential Address
DOB
Role
Photo ID on File
Yes
No
Name
Residential Address
DOB
Role
Photo ID on File
Yes
No
Please Check all That Apply
Services Interested in
Business Tax Preparation
Check
Bookkeeping
Check
Tax planning
Check
1099 Generation
Check
IRS Correspondence
Check
Sales tax filing
Check
Bookkeeping Services
Yes
No
Frequency
Software used
Payroll Service
Point of Sale (POS)
No. of bank accounts
No. of CC accounts
No. of business loans
No. of business LOC's
Other client concerns:
By signing below, you confirm you have provided the most up to date information.
Client Signature
*
Date
*
Internal use only
Location:
Partner:
Pricing:
IRS Corr
Federal
State
Other
Next Steps
Business EIN
Submit
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