Bookkeeping Client Intake Form

Information you will need

• Do you want to upload the Clinic's logo? af image
• SERVICE PROVIDER ONLY: What's your name?
• CLIENT ONLY: What’s your name?
• What's your address?
• What's your primary phone number?
• What's your secondary phone number?
• What's your email address?
• What's your secondary email address?
• What's the company’s legal name?
• What's the company’s DBA name?
• What's the company's address?
• What's the company’s industry or primary business activity?
• What's the entity type?
• What's the company’s date of incorporation?
• What's the company’s tax identification number?
• When does the company's fiscal year end?
• What's the company’s gross yearly revenue?
• How many employees does the company have?
• What's the first officer or owner's name?
• What's the first officer or owner's title?
• What's the first officer or owner's ownership percentage?
• Does the company operate on a fiscal or calendar basis?
• What's the second officer or owner's name?
• What's the second officer or owner's title?

…and 43 more fields in the PDF.

Completed by the client.

The form includes 1 signature line, a notary acknowledgment.