[Firm Name] New Client or New Service Set-up Form
COMPLETE ALL ITEMS BEFORE REQUESTING FILE OR CLIENT NUMBER! New Client Client #: -ORNew Service to Existing Client Date Opened:
Engagement #:
Client or Engagement Name: Attention Name/Title: Address: Address: City: Telephone #: Cell Phone #: Email: Social Security Number: Federal Identification Number: Tax Return Due Date: Date of Incorporation: Original TCFTR Due Date: Spouse's SS Number: Fiscal Year End Month: State of Incorporation: Franchise Report Required: Yes No Beginning Annual TCFTR Due Date: State: Fax #: Website: Zip Code:
Entity Type:
Trust-1041 L.L.C.-1040 Corp.1120
Trust-990 Partnership-1065 S Corp.-1120S
Estate-1041 L.L.C.-1065 Non-Profit-990
Estate-706 Partnership-1120 Retirement Plan-5500
Individual-1040 L.L.C.-1120 FALS
Department:
ACS
RPS
FALS
Tax
ASD
INCOME/BILLING/COMMISSION INFORMATION Number of Employees: AGI over $100,000 (for individuals): Estimated Engagement Fee: NAICS Code: Primary Partner: Originated By: Yes No Approx. Gross Revenue: Number of Offices: A/R Credit/WIP Limit: Bill Manager: Commission Due To:
Billing Responsible Ptnr.
Partner Initials
FILE REQUESTS File Year: Green Divided Blue Divided Return file to: 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 K – Related to a current client
L – Legal Niche
M – Medical Niche O – Other (Explain):
R – Referral Source
BOTH SIDES OF THE FORM MUST BE COMPLETED BEFORE WE CAN PROCESS!
PROJECT MANAGEMENT Project Type:
ACS Write-up (frequency)
Annual W-2's Business Tax Returns: Payroll Tax Returns 1065 1120 1120S Sales & Rental Tax Returns Personal Property 1099's
Employee Benefits Plan Financial Statements Compilation 706 990 Review 1040 1041 Other Franchise Due Date: Due Date: (list all) BUDGET (Attach detail) Total Hours: Total Dollars: $ (list all) Audit
Other Tax Returns:
Other State Returns:
FOR NEW CLIENT ONLY (If not new client, skip this section) 1. 2. 3. 4. 5. 6. 7. 8. Describe client’s business activity: 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? 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? 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: Cross-sold by staff: Peer/Accounting Firm: Prospect contacted us: Referred by Attorney: Referred by Employee: Former Client: Other: Personal Acquaintance: Referred by Banker: Referred by Client: Vendor Referral:
Name:___________________________________________ Company: ____________________________________ MARKETING REQUESTS Leading Edge FA- Dir. Mail Yr. End Tax Welcome Letter FALS Dir. Mailer Auto Fringe Ben Auto News Legal Const. Advisor Master Tax Const. Dir Mail Estate Plan RPS Mail
Med. News
Tax Update
Auto Seminar
Note: Needs approval by two Credit Committee Partners, or, if $1,500 or less, forward to [Firm Administrator].
CREDIT COMMITTEE APPROVAL: Partner: Partner:
OR DENIAL: Date: Date: