Business Client Information Sheet

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Business Client Information Sheet
Page 1 of 2
General Client Information:
Client Legal Name: ______________________________________________________
Client Address: _________________________________________________________
City, State, Zip:_________________________________________________________
Local Phone:___________________Fax:_____________E-Mail:__________________
Federal ID #:___________________ Web Site:________________________________
Entity Type: ____________________Year End:________________________________
Type of Business:_______________________________________________________
Other Locations:________________________________________________________
Incorporation Date (Provide Copy of Approval): _______________________________
S Corporation Approval Date (Provide IRS Approval Letter):______________________
Referral Source:_________________ # of Employees:___________ Union?_________
Contact:________________________ Bookkeeper:____________________________
Attourney:_______________________ Phone: ____________Fax:_________________
Bank:__________________________Officer:________________Phone:____________
Owners Names:______________________________ # of Shares:_________________
Owners Names:______________________________ # of Shares:_________________
Owners Names:______________________________ # of Shares:_________________
Owners Names:______________________________ # of Shares:_________________
Owners Names:______________________________ # of Shares:_________________
Family Relationship Descriptions:___________________________________________
______________________________________________________________________
Related Parties or Businesses:_____________________________________________
______________________________________________________________________
______________________________________________________________________

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