New Client Or New Service Set-Up Form

[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

Client #: / Engagement #: / Date Opened:
Client or Engagement Name:
Attention Name/Title:
Address:
Address:
City: / State: / Zip Code:
Telephone #: / Fax #:
Cell Phone #: / Website:
Email:
Social Security Number: / Spouse's SS Number:
Federal Identification Number: / Fiscal Year End Month:
Tax Return Due Date: / State of Incorporation:
Date of Incorporation: / Franchise Report Required: / Yes No
Original TCFTR Due Date: / Beginning Annual TCFTR Due Date:

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

Number of Employees: / Approx. Gross Revenue:
AGI over $100,000 (for individuals): Yes No / Number of Offices:
Estimated Engagement Fee: / A/R Credit/WIP Limit:
NAICS Code: / Bill Manager:
Primary Partner: / Commission Due To:
Originated By: / Billing Responsible Ptnr. / Partner Initials

FILE REQUESTS

File Year: / Return file to:

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:

ACS Write-up (frequency)

Annual W-2's Payroll Tax Returns Sales & Rental Tax Returns 1099's

Business Tax Returns: 1065 1120 1120S Personal Property

Employee Benefits Plan

Financial Statements Compilation Review Audit

Other Tax Returns: 706 990 1040 1041

Other

Franchise / Due Date:

Other State Returns:

Due Date:

(list all)(list all)

BUDGET

(Attach detail)

Total Hours: / Total Dollars: / $

FOR NEW CLIENT ONLY (If not new client, skip this section)

1.Describe client’s business activity:

2.Are services and/or reports intended to satisfy regulatory requirements or third parties? Y N

If so, for whom?

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

Would service to this company cause independence problems or conflicts of interest? Y N

If yes, why?
6.Why is management changing accountants?

State any other comments or observations that might affect our decision as to whether we accept this client:
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)

Association: / Prospect contacted us: / Former Client: / Referred by Banker:
Cross-sold by staff: / Referred by Attorney: / Other: / Referred by Client:
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].

CREDIT COMMITTEE APPROVAL: / OR DENIAL:
Partner: / Date:
Partner: / Date: