[Name]
New
Client or New Service Set-up
Form
COMPLETE
ALL ITEMS BEFORE REQUESTING FILE OR CLIENT
NUMBER!
New
Client
-OR-
New
Service to Existing Client
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Client
or Engagement Name: |
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Attention
Name/Title: |
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Address: |
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Address: |
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City: |
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State: |
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Zip
Code: |
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Telephone
#: |
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Fax
#: |
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Cell
Phone #: |
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Website: |
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Email: |
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Social
Security Number: |
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Spouse's
SS Number: |
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Federal
Identification
Number: |
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Fiscal
Year End Month: |
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Tax
Return Due Date: |
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State
of Incorporation: |
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Date
of Incorporation: |
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Franchise
Report Required: |
Yes
No |
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Original
TCFTR Due Date: |
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Beginning
Annual TCFTR Due
Date: |
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Entity
Type: Trust-1041
Trust-990
Estate-1041
Estate-706 Individual-1040
L.L.C.-1040
Partnership-1065
L.L.C.-1065
Partnership-1120
L.L.C.-1120
Corp.1120
S
Corp.-1120S
Non-Profit-990
Retirement
Plan-5500
FALS
Department:
ACS
RPS
FALS
Tax
ASD
INCOME/BILLING/COMMISSION
INFORMATION
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Number
of Employees: |
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Approx.
Gross Revenue: |
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AGI
over $100,000 (for individuals):
Yes
No |
Number
of Offices: |
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Estimated
Engagement Fee: |
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A/R
Credit/WIP Limit: |
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NAICS
Code: |
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Bill
Manager: |
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Primary
Partner: |
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Commission
Due To: |
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Originated
By: |
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Billing
Responsible Ptnr.
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Partner
Initials |
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FILE
REQUESTS
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File
Year: |
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Return
file to: |
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Green
Divided
Blue
Divided
Audit
File
Audit
Perm File
Green
None
ACCEPTANCE CODES:
(Choose
only one)
A
– ‘A’ Client
B –
‘B’ Client
H –
High Wealth
F –
LGT Financial Advisors
C –
Construction Niche
L –
Legal Niche
M –
Medical Niche
K –
Related to a current client
R –
Referral Source
O –
Other (Explain):
BOTH
SIDES OF THE FORM MUST BE COMPLETED BEFORE WE CAN
PROCESS!
PROJECT MANAGEMENT
Project
Type:
Annual
W-2's
Payroll Tax
Returns
Sales &
Rental Tax Returns
1099's
Business Tax
Returns:
1065 1120 1120S
Personal
Property
Financial Statements
Compilation
Review
Audit
Other Tax
Returns:
706
990
1040
1041
Other
Other State Returns: |
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Due
Date: |
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(list all)
(list all)
BUDGET
(Attach
detail)
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Total
Hours: |
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Total
Dollars: |
$
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FOR
NEW CLIENT ONLY
(If not new client, skip this
section)
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1.
Describe client’s business activity: |
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2.
Are services and/or reports intended to
satisfy regulatory requirements or third
parties?
Y
N
3.
Who
are the major stockholders (partners or owners)
and what is their percentage of
ownership?
4.
Has the company sued the prior accountants
or other professionals?
Y
N
5.
Would
service to this company cause independence
problems or conflicts of interest?
Y
N
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If yes, why? |
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6.
Why is management changing accountants? |
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7.
State
any other comments or observations that might
affect our decision as to whether we accept this
client:
8.
Have
we done our due diligence with the predecessor
CPA?
Y
N
N/A If no,
explain why:
MARKETING
METHOD (List name of referral
source)
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Association: |
Prospect
contacted us: |
Former
Client: |
Referred
by Banker: |
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Cross-sold
by staff: |
Referred
by Attorney: |
Other: |
Referred
by Client: |
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Peer/Accounting
Firm: |
Referred
by Employee: |
Personal
Acquaintance: |
Vendor
Referral: |
Name:___________________________________________ Company:
____________________________________
MARKETING
REQUESTS
Leading
Edge
Welcome
Letter
Auto
News
Const.
Advisor
Const. Dir
Mail
Estate
Plan
FA-
Dir. Mail
FALS
Dir. Mailer
Legal
Master
Tax
Med.
News
Tax
Update
RPS
Mail
Yr. End
Tax
Auto Fringe
Ben
Auto
Seminar
Note: Needs
approval by two Credit Committee Partners, or, if
$1,500 or less, forward to [Firm
Administrator].
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CREDIT
COMMITTEE
APPROVAL: |
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OR
DENIAL: |
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Partner:
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Date: |
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Partner:
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Date: |
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