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Client Intake
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Client Intake
WHAT SERVICES ARE YOU HAVING COMPLETED?
*
Business Structuring
Bookkeeping
BUSINESS STRUCTURING
PLEASE PROVIDE CHOSEN NAME FOR THE BUSINESS:
*
ARE YOU REQUESTING THE FOLLOWING:
*
SOLE PROPRIETORSHIP
LIMITED LIABILITY COMPANY (LLC)
S CORP
PARTNERSHIP
WILL YOU HAVE EMPLOYEES?
*
YES
NO
WILL YOU PAY OWNER'S W2 INCOME?
*
YES
NO
NAME OF INSURANCE AGENT:
*
DO YOU NEED A CONTRACTOR'S LICENSE?
*
YES
NO
PRIMARY CONTACT
*
Email Address
*
Phone
*
PERSONAL INFORMATION OWNER(S)
HOW MANY OWNERS?
*
ONE
TWO
MORE
FIRST OWNER INFORMATION
FULL LEGAL NAME:
*
DATE OF BIRTH
*
SSN
*
Email Address
*
Phone
*
Street Address
*
Apartment, suite, etc
*
City
*
State/Province
*
ZIP / Postal Code
*
Country
*
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Australia
Aruba
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cabo Verde
Cayman Islands
Central African Republic
Chad
Chile
China, People's Republic of
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
France, Metropolitan
French Guiana
French Polynesia
French South Territories
Gabon
Gambia
Georgia
Germany
Guernsey
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island And Mcdonald Island
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Johnston Island
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
North Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion Island
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
Saint Helena
Saint Pierre & Miquelon
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and South Sandwich
Spain
Sri Lanka
Stateless Persons
Sudan
Sudan, South
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan, Republic of China
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
US Minor Outlying Islands
United States of America (USA)
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis And Futuna Islands
Western Sahara
Yemen
Zambia
Zimbabwe
BUSINESS INFORMATION
IS THE BUSINESS INFORMATION DIFFERENT FROM ABOVE?
*
YES
NO
IS THE BUSINESS ADDRESS DIFFERENT FROM ABOVE?
*
YES
NO
PLEASE VERIFY THE FOLLOWING BEFORE SUBMITTING:
*
I agree, that I have filled the following form above to the best of my ability.
BOOKKEEPING
DO YOU CURRENTLY USE BOOKKEEPING SOFTWARE?
*
YES
NO
If Yes, you will be requested for login information.
HOW MANY BUSINESS BANK ACCOUNTS?
*
We will be requesting login information.
PLEASE PROVIDE YOUR BANK(S) NAME(S):
*
We will be requesting login information.
DO YOU CURRENTLY USE CREDIT CARD(S) FOR BUSINESS PURCHASES?
*
YES
NO
If Yes, you will be requested for login information.
DOES YOUR COMPANY CURRENTLY HAVE LOAN ACCOUNT(S)?
*
YES
NO
If Yes, you will be requested for login information.
DO YOU HAVE A LIST OF YOUR COMPANY'S ASSETS & VALUES?
*
YES
NO
Vehicles, equipment, building, etc.
DO YOU FILE A MONTHLY, QUARTERLY OR ANNUAL DEPARTMENT OF REVENUE RETURN?
*
MONTHLY
QUARTERLY
ANNUAL
DO YOU WANT COMPLETE BUSINESS SOLUTIONS TO FUNCTION AS YOUR ACCOUNTS PAYABLE DEPARTMENT?
*
YES
NO
DO YOU NEED US TO ORDER LASER PRINT BUSINESS CHECKS?
*
YES
NO
DO YOU WANT COMPLETE BUSINESS SOLUTIONS TO INVOICE YOUR CUSTOMERS FOR YOUR BUSINESS?
*
YES
NO
DO YOU USE A MERCHANT SERVICE TO ACCEPT ELECTRONIC PAYMENTS?
*
YES
NO
Examples: Square Talech Vagaro
DO YOU WANT THE ABILITY TO REMOTELY ACCESS YOUR QUICKBOOKS COMPANY FILE?
*
YES
NO
(Note: Cost: $25/month)
DO YOU WANT US TO PERFORM PAYROLL SERVICES?
*
YES
NO
WHAT STATE(S) DO YOUR EMPLOYEES WORK IN?
*
You can separate multiple states with commas if required to list more than one.
HOW MANY EMPLOYEES?
*
Note: We will be requesting completed employment documentation for each employee.
DO YOU HAVE A HIRING ENDORSEMENT ON YOUR BUSINESS LICENSE?
*
YES
NO
DO YOU HAVE AN EFTPS ACCOUNT?
*
YES
NO
DO YOU WANT TO PAY YOUR EMPLOYEES VIA DIRECT DEPOSIT OR PRINTED CHECK?
*
DIRECT DEPOSIT
PRINTED CHECKS
HOW OFTEN DO YOU PAY YOUR EMPLOYEES?
*
WEEKLY
MONTHLY
SEMI-MONTHLY
BI-WEEKLY
WHAT IS THE FIRST PAY DATE?
*
WHAT IS THE FIRST PAY PERIOD END DATE FOR THE FIRST PAY DATE?
*
DO ANY OF YOUR CURRENT EMPLOYEES HAVE WAGE GARNISHMENTS?
*
YES
NO
DO YOU OFFER MEDICAL OR OTHER EMPLOYEE BENEFITS?
*
YES
NO
DO YOU AS THE OWNER COLLECT A PAYCHECK VIA PAYROLL (W2 INCOME)?
*
YES
NO
DO YOU AS THE OWNER PAY FOR HEALTH INSURANCE VIA THE COMPANY?
*
YES
NO
DO YOU ALLOW YOUR EMPLOYEES TO TAKE PAYCHECK DRAWS?
*
YES
NO
DO YOU LOAN YOUR EMPLOYEES MONEY WITH THE EXPECTATION THAT REPAYMENT IS MADE VIA PAYROLL DEDUCTION?
*
YES
NO
PERSONAL INFORMATION OWNER(S)
HOW MANY OWNERS?
*
ONE
TWO
MORE
FIRST OWNER INFORMATION
FULL LEGAL NAME:
*
D.O.B. (DATE OF BIRTH):
*
SSN:
*
Email Address
*
Phone
*
Street Address
*
Apartment, suite, etc
*
City
*
State/Province
*
ZIP / Postal Code
*
Country
*
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Australia
Aruba
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cabo Verde
Cayman Islands
Central African Republic
Chad
Chile
China, People's Republic of
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
France, Metropolitan
French Guiana
French Polynesia
French South Territories
Gabon
Gambia
Georgia
Germany
Guernsey
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island And Mcdonald Island
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Johnston Island
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
North Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion Island
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
Saint Helena
Saint Pierre & Miquelon
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and South Sandwich
Spain
Sri Lanka
Stateless Persons
Sudan
Sudan, South
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan, Republic of China
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
US Minor Outlying Islands
United States of America (USA)
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis And Futuna Islands
Western Sahara
Yemen
Zambia
Zimbabwe
BUSINESS INFORMATION
IS THE BUSINESS INFORMATION DIFFERENT FROM ABOVE?
*
YES
NO
IS THE BUSINESS ADDRESS DIFFERENT FROM ABOVE?
*
YES
NO
PLEASE VERIFY THE FOLLOWING BEFORE SUBMITTING:
*
I agree, that I have filled the following form above to the best of my ability.
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