DE NOVO Tax & Advisors
Business Client Information Form
Business Name (As shown on tax return)
Business Name/Disregarded Entity Name, if different from above
Type of Business (1120S, 1120C, 1065, LLC, 990, 1041)
State Registered
EIN # OR Social Security #
Business Phone #
Format: (000) 000-0000.
Business Fax #
Format: (000) 000-0000.
Website:
Business Street Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Individual Responsible for Tax Filing
First Name, MI, Last Name (Legal Name)
First Name
Last Name
Title (President, Member, Partner, Other)
Nickname
Email Address
example@example.com
Social Security #
Mobile Phone #
Format: (000) 000-0000.
Home Phone #
Format: (000) 000-0000.
Preferred Method of Contact:
Business
Mobile
Home
Email
Home Street Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Miscellaneous Informaton
Bookkeeper's Name
Bookkeeper's Phone #
Format: (000) 000-0000.
Payroll Company's Name
Payroll Company's Phone #
Format: (000) 000-0000.
How did you hear about Denovo?
Online
Referral
Referral Name:
Please provide SS4 Form for a new business
This completed form, as well as your tax returns, contain Personally Identifiable Information (PII). They should only be transmitted through our secure client portal, Liscio. They should not be attached to a standard email.
Submit
Should be Empty: