Client Set-Up Form template by katrinagolden

VIEWS: 2,667 PAGES: 3

									ROUTING:             Director             [Partner 1]                 [Partner 2]
                     [Partner 3]             [Partner 4]


                                                           C L I E N T              I N F O R M A T I O N

Completed By:                             Date:                                              Client Number:                                 Engagement Number:
Status:     Active Client     Active Prospect           Active Referral Source               Engagement Description:
                                 (Check one)                                                 Retain Files Indefinitely?               Yes               No




                      NAME and ADDRESS                                                                     MAILING ADDRESS (if different)
                                                                                             Attention Name:
Client Name:                                                                                 Client Name:
Address Line One:                                                                            Address Line One:
Address Line Two:                                                                            Address Line Two:
Address Line Three:                                                                          Address Line Three:
City:                              State:              Zip:                                  City:                                State:           Zip:
Telephone #:                                  Fax #:                                         Email Address:
Client Type*:                      Fiscal Year End:                                   Department*:      C        F        N       SIC Code**:
                                                                                                            (Check one)
Federal ID#:                                   Social Security #:                                             Spouse Social Security #:
Primary Director:           Bill Manager:                     Tax Reviewer:               Client’s Annual Revenue*:                  Client’s # of Employees*:




                                                        C O N T A C T                I N F O R M A T I O N

    Contact Name                 Telephone                Telephone2                    Email                    Title               Salutation             Mailings
                               (Enter code before #)     (Enter code before #)                                                                        (Please circle – see below)
                                                                                                                                                     1 2        3 4        5 6


                                                                                                                                                     1 2        3 4        5 6


                                                                                                                                                     1 2        3 4        5 6



Codes for Phone #’s:
C = Cell            H = Home                  W = Work                  P = Pager            F = Fax

Mailings:
1 = Newsletter – Quarterly Think Black Ink                              3 = Planning Guide                           5 = Special Year-End Mailing (calendar, card, etc.)
2 = Newsletter – Quarterly Technology                                   4 = Payroll Deposit Schedule                 6 = Newsletter – Family Business Today



                                  B U S I N E S S                D E V E L O P M E N T                 I N F O R M A T I O N

Employee Responsible for Acquiring Client:                                                   Referral Responsible for Acquiring Client:
Referred How*?
Law Office:                                                                Attorney Name:                                    Phone #:
Bank:                                                                      Banker Name:                                      Phone #:
Comments:

*Please refer to the back of this form for these codes.
**SIC Code: Please refer to Consolidated SIC Code Listing which is located in Outlook Public Folders under Forms.
                                              SERVICE INFORMATION

           Service                    Y              Fee                                 Service                          Y             Fee

Tax Preparation                                                              Human Resource Consulting
Tax Planning                                                                 Predictive Index
Audit                                                                        Information Technology
Review                                                                       Consulting/Advice
Exam                                                                         WYFA Services:
Compilation                                                                       Insurance
Controllership                                                                    Retirement Plan Design
Payroll Preparation                                                               Investments
Payroll Quarterly                                                            Other:
Payroll Tax                                                                  Other:


Engagement Fee:




                                                              CODES


Client Type:          1    =   Attorney                           Client’s # of    1      =     1 – 10
                      2    =   Bank                                Employees:      2      =     11 – 20
                      3    =   C Corporation                                       3      =     21 – 50
                      4    =   Credit Union                                        4      =     51 – 100
                      5    =   Individual                                          5      =     101 – 150
                      6    =   Joint Venture                                       6      =     151 – 200
                      7    =   NPO-GFP Training Seminar                            7      =     201 – 250
                      8    =   NPO–Grant Funded Organization                       8      =     > 250
                      9    =   NPO-Private Foundation
                      10   =   NPO-Trade/Membership Association   Referred         1      =     Client Expansion
                      11   =   Partnership                         How?            2      =     Personal Contact
                      12   =   Pension/Profit Sharing                              3      =     Client “Introduction”
                      13   =   Sole Proprietorship                                 4      =     Direct Mail
                      14   =   Trust                                               5      =     Public Relations or Advertising Programs
                      15   =   Sub S Corporate                                     6      =     Banker/Attorney “Introduction” (or “other” referral
                                                                                                source)
                                                                                   7      =     NPO RFP
Department:           C    = Commercial                                            8      =     GFP Training, Direct Mail, etc.
                      F    = FIG                                                   9      =     GFP Internet Service
                      N    = NPO                                                   10     =     Merger/Acquisition (i.e., McNally)

Client’s Annual       1    =   $0 - $249,999                      Engagement       1      =     $0 - $500
 Revenue:             2    =   $250,000 - $499,999                 Fee:            2      =     $501 - $1,000
                      3    =   $500,000 - $999,999                                 3      =     $1001 - $1,500
                      4    =   $1M - $4M                                           4      =     $1,501 - $2,500
                      5    =   $5M - $7M                                           5      =     $2,501 – $3,500
                      6    =   $8M - $14M                                          6      =     $3,501 – $5,000
                      7    =   $15M - $24M                                         7      =     $5,001 - $7,500
                      8    =   $25M - $49M                                         8      =     $7,501 - $10,000
                      9    =    $50M                                              9      =     $10,001 - $12,500
                                                                                   10     =     $12,501 - $15,000
                                                                                   11     =     $15,001 - $20,000
                                                                                   12     =     $20,001 - $30,000
                                                                                   13     =     $30,001 - $40,000
                                                                                   14     =     $40,001 - $60,000
                                                                                   15     =     $60,001 +
        Consolidated                                SIC     Listing

100     Agriculture
1000    Mining
1500    Construction
2000    Manufacturing
4000    Transportation
4800    Communications – Radio/TV
4900    Public Utilities
5000    Wholesale Trade
5200    Retail Trade
6000    Banks – Depository & Non-Depository
6100    Credit Unions
6200    Security & Commodity Brokers
6300    Insurance – Carriers, Agents, Brokers, Service
6500    Real Estate
6700    Holding Companies, Trusts, Investing
7300    Services – Business
7900    Services – Other
8000    Services – Medical/Dental
8100    Services – Legal
8200    NPO – Education/Schools
8300    NPO – CAP Agencies/HS
8400    NPO – SDA
8500    NPO – Community-Based Organizations
8600    NPO – Membership Organizations/Trade Associations
9100    Public Administration/General Government
99999   Individuals

								
To top