CONSULTATION
"Redefining Financial Success - The Black Tie Way"
CLIENT INFORMATION
Basic Info
Full legal name
*
First Name
Last Name
Preferred Name
Date of birth
*
-
Month
-
Day
Year
DOB
Phone Number
*
Email address
*
example@example.com
Service Information
Are you an individual or a business?
Individual
Business
Both
SERVICES NEEDED (KEY SECTION)
Which services are you interested in? (Check all that apply)
Credit Repair
Credit Building
Personal Tax Preparation
Business Tax Preparation
Bookkeeping
Payroll & Reporting
LLC / Business Setup
CREDIT REPAIR & CREDIT BUILDING SECTION
Current Credit Situation
Do you know your current credit score range?
Under 500
500–579
580–659
660–719
720+
Not sure
Have you pulled your credit reports in the last 30 days?
Yes
No
Negative Items (Check all that apply)
Late payments
Collections
Charge-offs
Evictions
Repossessions
Bankruptcies
Student loans
Medical bills
Not sure
Credit Goals
What are you trying to qualify for?
Home purchase
Auto loan
Business funding
Credit cards
Lower interest rates
Not sure
Target credit score goal:
Desired timeline (e.g., 3–6 months, 6–12 months):
3 months
6 months
9 months
12 months (1 year)
24 months (2 years)
36 months (3 years)
PERSONAL TAX PREPARATION SECTION
Which tax year(s) need to be filed?
Have you filed taxes for the previous year?
Yes
No
Filing status:
Single
Married Filing Jointly
Married Filing Separately
Head of Household
Do you have:
W-2 income
1099 income
Self-employment income
Any of the following?
Dependents
Child tax credit
Education expenses
Rental property
Cryptocurrency
Do you owe back taxes?
Yes
No
Not sure
BUSINESS INFORMATION (FOR BUSINESS SERVICES)
Business legal name (if applicable)
Business structure:
Sole Proprietor
LLC
S-Corp
C-Corp
Not formed yet
State of registration
EIN (if available)
Business start date
-
Month
-
Day
Year
Date
Primary business activity
Business bank account?
Yes
No
BUSINESS TAX PREPARATION SECTION
Tax years needed:
Estimated annual revenue:
Under $25k
$25k–$75k
$75k–$150k
$150k+
Have books been maintained?
Yes
No
Any of the following?
Sales tax
Contractors (1099s)
Employees
Do you owe business back taxes?
Yes
No
Not sure
BOOKKEEPING SECTION
Do you currently track income and expenses?
Yes
No
Software used:
QuickBooks
Wave
Excel
None
Frequency needed:
Monthly
Quarterly
Catch-up bookkeeping
How many months are behind (if any)?
PAYROLL & REPORTING SECTION
Do you currently have employees?
Yes
No
Number of employees:
Are payroll taxes being filed?
Yes
No
Not sure
Payroll frequency:
Weekly
Bi-weekly
Monthly
Do you need:
Payroll setup
Ongoing payroll processing
Quarterly/annual payroll reports
LLC / BUSINESS SETUP SECTION
Are you starting a new business?
Yes
No
Desired business structure:
LLC
S-Corp election
Not sure (need guidance)
State you want to register in:
Do you need:
EIN
Operating Agreement
Business bank setup guidance
Compliance guidance
GOALS & EXPECTATIONS
What are your top 3 goals for working with us?
What does success look like for you in the next 6–12 months?
Timeline urgency:
ASAP
30 days
60–90 days
Preferred communication method:
Email
Phone
Text
Virtual meeting
10. FINAL ACKNOWLEDGEMENTS
How did you hear about us?
Have you worked with a credit or tax professional before?
Yes
No
Do you agree that this form does not create a client relationship until services are formally engaged?
*
Yes
SAVE & CONTINUE LATER
SUBMIT
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