Please complete this short form relating to your business.
Business Legal Name
Business DBA
Federal Identification Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Point of Contact for Business
First Name
Last Name
Phone Number
Email
example@example.com
Preferred Method of Contact
Email
Phone
Did you make any payments in 2023 that would require you to file Form(s) 1099
YES
NO
If "Yes", did you file required Form(s) 1099?
YES
NO
Have you signed our current tax engagement letter?
YES
NO
Notes/Comments
Partner or Shareholder Information
Name
*
First Name
Last Name
SS
*
Partner/Shareholder % of Ownership at Year End
*
Shareholder/Partner #1 Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address
*
example@example.com
Telephone Number
*
Partner/Shareholder #2
First Name
Last Name
SSN
Partner/Shareholder % of Ownership at Year End
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address
example@example.com
Telephone Number
Partner/Shareholder #3
First Name
Last Name
SSN
Partner/Shareholder % of Ownership at Year End
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address
example@example.com
Telephone Number
Partner/Shareholder Name #4
First Name
Last Name
SSN
Partner/Shareholder % of Ownership at Year End
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address
example@example.com
Telephone Number
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