Date: _____________________

Company Name _______________________________________________________

Contact Name   _______________________________________________________

Address             _______________________________________________________

Telephone         _______________________________________________________

Cell phone        ________________________________________________________

Fax                   ________________________________________________________

Email               ________________________________________________________

Type of Company:        Service            Retail       Wholesale

Do you charge Sales Tax?_____

Type of Entity: C-Corp        S-Corp        Partnership        Sole Prop.        LLC    Other_____

Business start date:______________________

Who does Payroll?______________________

            Frequency: Weekly      Bi-weekly         Semi-Monthly            Monthly

            Number of Employees:_____        Number out-of-state_____

Who currently does your books? _______________________________________________________

            How long does it take them?_____________________________________________________

What software products are you using? __________________________________________________

Who does your taxes? ________________________________________________________________