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Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Format: (000) 000-0000.
Preferred Communication Method
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Email
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Type of Entity Requesting Services
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Individual
Estate/Trust
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Exempt Organization
Please list each person, family member, business, or trust/estate you’d like us to serve.
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Rows
Type of Entity
Name of Entity
1
Individual
Estate/Trust
LLC
S-Corp
C-Corp
Partnership
Sole Proprietor
Nonprofit
Other
2
Individual
Estate/Trust
LLC
S-Corp
C-Corp
Partnership
Sole Proprietor
Nonprofit
Other
3
Individual
Estate/Trust
LLC
S-Corp
C-Corp
Partnership
Sole Proprietor
Nonprofit
Other
4
Individual
Estate/Trust
LLC
S-Corp
C-Corp
Partnership
Sole Proprietor
Nonprofit
Other
5
Individual
Estate/Trust
LLC
S-Corp
C-Corp
Partnership
Sole Proprietor
Nonprofit
Other
6
Individual
Estate/Trust
LLC
S-Corp
C-Corp
Partnership
Sole Proprietor
Nonprofit
Other
7
Individual
Estate/Trust
LLC
S-Corp
C-Corp
Partnership
Sole Proprietor
Nonprofit
Other
8
Individual
Estate/Trust
LLC
S-Corp
C-Corp
Partnership
Sole Proprietor
Nonprofit
Other
9
Individual
Estate/Trust
LLC
S-Corp
C-Corp
Partnership
Sole Proprietor
Nonprofit
Other
10
Individual
Estate/Trust
LLC
S-Corp
C-Corp
Partnership
Sole Proprietor
Nonprofit
Other
Services of Interest
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Audit/Assurance
Consulting/Business Advisory
Individual Tax
Business Tax/Bookkeeping/Payroll
IRS
Other
Client/Business Information
What industry do you operate in?
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Agriculture
Construction
Employee Benefit Plans
Family Office & Owned Businesses
Healthcare
Manufacturing
Nonprofit
Private Equity & Investment Funds
Professional Services
Real Estate
Restaurant, Entertainment, Retail & Hospitality
Technology
Transportation
Veterinary Medicine
Other
Number of Employees
What accounting software do you use (if any)?
Preferences & Expectations
Preferred Location/Branch
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North Little Rock
Conway
Harrison
No preference
Have you worked with a CPA/Accounting firm in the past?
*
Yes
No
What has you considering a change?
What’s most important to you in working with a CPA firm? (responsiveness, industry expertise, proactive advice, local presence, etc.)
How did you hear about us?
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Employee Referral
Company Website
Social Media
Search Engine
Word of Mouth
Article / Print Ad
Other
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