Client Information Sheet
ADVERTISEMENT
1
2DATE: __________________
FILE CABINET ID ________________________
Payment is due at the time services are rendered
BUSINESS INFORMATION
Name: ________________________________________
Federal ID #: _____________________________________
Type of Entity:
Corporation: _____ C _____ S
Partnership: _____LP _____GP
Trust
SMLLC
(circle one)
Physical Address: ____________________________________________________________________________________
Mailing Address: _____________________________________________________________________________________
Phone: (________) _____________________
Fax: (_______) __________________ Year End: ____________
Is an EFTPS account already established? _____ yes _____no If not, please provide the following information:
Bank Name: ___________________________ Routing # _______________________ Account #_____________________
Contact Person: ______________________________________________________________________________________
Email Address: _______________________________________________________________________________________
Referred by: _________________________________________________________________________________________
PERSONAL INFORMATION
** Copies required for new clients
BUSINESS OWNER/PARTNER INFORMATION:
Name: _________________________________________________
SS#: **________________________________
Driver’s License #: **___________________ Ex Date: __________
Date of Birth: ___________________________
Address: _________________________________________________________________________________________
City, State Zip: ___________________________________________
Phone (hm): ___________________________
(work) _________________________________________________
(Cell) _________________________________
Email Address: ___________________________________________________________________________________
Title: ___________________________________________________
BUSINESS OWNER/PARTNER INFORMATION:
Name: _________________________________________________
SS#: **________________________________
Driver’s License #: **___________________ Ex Date: __________
Date of Birth: ___________________________
Address: _________________________________________________________________________________________
City, State Zip: ___________________________________________
Phone (hm): ___________________________
(work) _________________________________________________
(Cell) _________________________________
Email Address: ___________________________________________________________________________________
Title: __________________________________________________
***OVER***
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business