Prospective New Client Form

Individual Information

First Name First Name is required

Last Name Last Name is required

Address Address is required

City City is required

State State is required

Zip Code Zip Code is required

Phone Number Please enter a 10 digit phone number

Email Address Please enter a valid email address

Referred By Referred By is required

Last Tax Year Filed Last Tax Year Filed is required

Services Requested

Requested Services Tax Return Preparation Individual Financial Planning Estate Planning Retirement Planning

Requested Services is required

Additional Information

Business Information

Business Name

Contact Name

Physical Address

City

State

Zip Code

Business Phone Number Please enter a 10 digit phone number

Referred By

Describe Nature of the Business

Year Started

Entity Type

Business Entity Type S Corporation Partnership Sole Proprietor Trust Non-Profit

Business Entity Type is required

Services Requested

Requested Services Tax Return Preparation Business Planning Tax Projections Cash Flow Management Tax Entity Election New Business Formation & Corporate Structuring Bookkeeping Payroll State and Local Tax Filings Financial Statement Preparation Success Planning QuickBooks Training & Consulting