New Client Questionnaire

    Client's Name: *

    Spouse's Name:

    Home Address: *

    City: *

    State: *

    Zip: *

    Home Phone: *

    Work Phone:

    Cell Phone: *

    Spouse's Cell Phone:

    Email Address: *

    Spouse's Email Address:

    AREAS OF INTEREST (Please check all that apply):


    Tax PreparationTax Planning & Tax AnalysisIRS Representation – Problems & Resolutions


    Accounting/Bookkeeping servicesEntity Selection Analysis (LLC, C-Corp, S-Corp)Payroll Services – Analyze the OptionsStart-up QuestionsCredit Card Processing DiscountsGeneral Business Consulting


    Review of GoalsRetirement Planning401K RolloverTax Deferral – Business (SEP, SIMPLE, IRA, 401k, other)Social Security


    Quote Personal Lines Insurance (Homeowners, Auto, Flood, Umbrella)Quote Commercial Lines Insurance (Liability, Workers Comp, Auto, Umbrella, Commercial Property, Malpractice, E&O, Professional)Quote Health/Life InsuranceQuote Boat/Marine/RV/ATV/Golf Cart

    Questions, concerns or changes in your financial or business status:

    ***If you have it, please provide a copy of your past year’s individual and business (if any) tax return***
    (If you are unable to upload at this time, please bring a physical copy to your meeting)