DATE: ________________________________
BUSINESS
NEW CLIENT QUESTIONNAIRE
COMPANY NAME: _____________________________________________________________
TRADE NAME IF APPLICABLE: _________________________________________________
ADDRESS ____________________________________________________________________
CITY
PHONE: _____________________________ FAX: ____________________________________
CELL OR BEEPER: ______________________ EMAIL: _______________________________
OWNER’S NAME: _____________________________________________________________
OWNER’S ADDRESS: __________________________________________________________
PHONE: _____________________________ FAX: ____________________________________
CELL OR BEEPER: ______________________ EMAIL: _______________________________
TYPE OF BUSINESS: ___________________________________________________________
DATE BUSINESS STARTED: ______________ DATE OF INCORPORATION ____________
STATE OF INCORPORATION ___________________________________________________
FEDERAL TAX ID #:
I/We, _______________________________ (taxpayer(s) acknowledge that all information provided here for the preparation and completion of my Federal and state taxes is complete and accurate to the best of my knowledge. I/We also understand and agree that a 50% deposit is due when work is accepted and that payment in full is due when work is completed.
I/We have read all the information furnished and agree to all terms and conditions.
_________________________________ ________________________________
TAXPAYER’S SIGNATURE SOCIAL SECURITY NUMBER
_________________________________ ________________________________
TAXPAYER’S SIGNATURE SOCIAL SECURITY NUMBER