.E - My CPA, PA Potential Client Discovery Form

My CPA, PA Potential Client Discovery Form

This information will be used to assist in determining if our firm can assist with your accounting, tax, and advisory needs.
Estimated time to complete: less than 5 minutes
Contact Information
Contact Full Name*

First NameLast Name
Primary Email*
example@example.com
Contact Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Entity Type (select all that apply)*

IndividualIndividual w/ Sch C (reports income/loss from a business you operated or a profession you practiced as a sole proprietor)Individual w/ Sch E (to report profit or loss from rental real estate)Individual w/ Sch F (reports profit or loss from Farming)TrustC-CorpS-CorpPartnershipEstateNon-ProfitOther
Do you own a rental property?*
Do you own a business?*
Business Name *
Who are the primary decision-makers for your business?*
Full Business Address (if different than that provided above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What does your company do?*

Accounting ServicesAgricultureArchitectConstruction - New HomesConstruction - RemodelConsultingEducation/TrainingFinancial Planning ServicesHealth ServicesInsurance Agent (Commission Income)Legal Services - AttorneyManagement ServicesManufacturingPerforming ArtsReal Estate Agent (Commission Income)Retail SalesRestaurantSkilled Trade - Electrician, Plumber, Etc.Other (list)
Are you looking for us to complete your personal annual income tax return (form 1040)?*
Do you have the following items on your personal income tax return?*

Rental PropertyK-1 for a S-CorporationK-1 for a PartnershipK-1 for a TrustBrokerage StatementsCryptocurrency1099-NECHSA1095 - ADon't know or n/aOther
Please check the below box to confirm that you understand the minimum fee that we charge for clients who wish to only have their 1040s completed is $950.00.*

Confirmed
Referred By or any Relation to an Existing Client (optional)
If you were referred by someone or are connected to one of our existing clients, please specify.
Do you have a current CPA with whom you work? Why are you seeking to work with a new firm?*
What is the top problem or issue you need help with?*
Please select a date from the below calendar for us to meet for a new client consultation. Please ensure you schedule completely by CLICKING THE SCHEDULE EVENT BUTTON AT THE END and then continue on to submit this form!*
On a scale of 1 - 5 (with 1 being the least), how knowledgeable are you about how your taxes are structured or how your taxes work?*

1

2

3

4

5

1 is Not knowledgable, 5 is Very knowledgable
Anything additionally you'd like to provide, for us to review in advance of your consultation?

Cancelof
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My CPA, PA Potential Client Discovery Form

Contact Information