New Client Sheet - Individual - Associates In Accounting Cpa
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2New Client Sheet - Individual
Let’s talk about you!
Date
___________________________________
Taxpayer Last, First, Middle ______________________________Spouse Last, First, Middle _____________________________
Taxpayer Nickname
___________________________________Spouse Nickname
________________________________
Taxpayer Social Security Number _________________________Spouse Social Security Number ________________________
Taxpayer Date of Birth __________________________________Spouse Date of Birth ________________________________
Taxpayer Occupation __________________________________Spouse Occupation __________________________________
Please circle the primary way you would like us to communicate with you.
Home Phone
___________________________
Taxpayer Cell Phone
___________________________
Spouse Cell Phone
________________________________
Taxpayer Work Phone ___________________________
Spouse Work Phone _______________________________
Taxpayer Fax Number ___________________________
Spouse Fax Number _______________________________
Taxpayer Email
___________________________
Spouse Email
_______________________________
Home Address __________________________________________________________________________________
City
___________________________________ State _______________ Zip _____________________
County of Residence ______________________________
Dependent Information (If you need more room, please write this information on a separate sheet.)
Legal Name (as it appears on Social Security Card)
Relationship (Son or Daughter) Date of Birth
Social Security Number
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Do you have a Schedule C business?
YES
NO
Do you have an OL-3 account number? YES
NO
If YES, Business Name _______________________________ If YES, OL-3 account number _________________
If YES, Does Business Require KY Form 725
YES
NO
If YES, Software used ___QuickBooks, Version ___________
___Peachtree
___ Other ________
Password
_______________________________
If you are expecting tax refunds and would like your tax refund deposited directly from the
government entities into your checking account, please provide us with a voided check.
How did you hear about our firm?
Do you have a Facebook page?
_____ Referred by _______________
____ Yes
_____ No
_____ AT&T Real Yellow Pages
_____ Facebook
_____ Internet
Do you have a Twitter account?
_____ Twitter
____ Yes
_____ No
_____ Yellow White
_____ Other _______________
Do you have a Smart Phone?
Would you like to hear more about our online portal?
_____ Yes, Android
_____ Yes, IPhone
_____ Yes, please
_____ No, thank you
_____ No
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