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Name

Email Address

Phone Number

Cellular or Pager

Address

City

State

Zip

Business Name

Business Address

City

State

Zip

Business Phone

Business Web Address

Have you ever, or do you currently own your own business?
Yes No

What is your position with the business?

Approximately how many people does the business employ?

How is your business organized?
sole proprietorship
partnership
"S" corporation
"C" corporation
limited liability company

What is the general nature of your business?

How does your company complete its tax obligations?
all in-house
all done by tax professionals who are not employed by our company
combination of in-house and outside professionals

Has your company been audited by the IRS?
Yes No

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