Tax Intake Form | Ques For Success

Intake Form

Ques For Success AT Financial Corp Business Tax Intake Form

Please provide all required information and one of our consultants will contact you.

Date

First Name

Last Name

Date of Birth

SSN

Contact Information

Physical Address

Address Line 1

Address Line 2

City

State

Zip Code

Is Mailing Address Different that Physical Address?

Yes

Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

Personal Phone/Mobile

Personal Email

Business Name

Business Slogan or Trademark

Business Phone/Mobile

Business Email

About Your Business

Date Business Started

Date Registered w/WDFI

EIN

Which State Business Incorporated

Date Incorporated

Business Structure

Business Partner First Name

Business Partner Last Name

Percentage Owned %

Business Partner Address

Address Line 1

Address Line 2

City

State

Zip Code

Business Partner Phone #

Business Partner Email

Business Operating Agreement

Yes

Business Accounting Software

Payroll Service

Date Operating Agreement Signed

Taxes Filed

Select the tax forms that you have previously filed and state the last year they were filed.

Personal

Yes

Last Year Filed

Schedule C

Yes

Last Year Filed

Partnership 1065

Yes

Last Year Filed

Corporation 1120

Yes

Last Year Filed

Corporation 1120S

Yes

Last Year Filed

Non-Profit 990

Yes

Last Year Filed

Sales and Use Tax

Yes

Last Year Filed (if applicable)

Have you recently received letter from IRS or State Agency regarding your business and/or personal taxes?

Yes

Insurance

Business Insurance

Yes

Amount $

Name of Company

Current

Yes

Unemployment Insurance

Yes

Amount $

Name of Company

Current

Yes

Liability Insurance

Yes

Amount $

Name of Company

Current

Yes

Banking

Business Checking Account

Yes

Name of Financial Institution

Business Savings Account

Yes

Name of Financial Institution

Personal Checking Account

Yes

Name of Financial Institution

Primary Owner Name

First Name

Last Name

By checking this box, I, agree to have the information I provided stored and used by Ques For Success AT Financial Corp for the purpose of servicing my business and tax needs. I understand that my data will be handled in accordance with the company's Privacy Policy.

Ques For Success AT Financial Corp Business Tax Intake Form

Contact Information

About Your Business

Business Structure

Taxes Filed

Insurance

Banking

Primary Owner Name

Monday - 7:00AM to 2:00PM

Tuesday - 7:00AM to 2:00PM

Wednesday - 7:00AM to 2:00PM

Thursday - 7:00AM to 2:00PM

Fri to sun - Closed

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