KFWE Business Services Client Intake

1
First Name* This field is required.
First Name
Last Name
2
Last Name* This field is required.
First Name
Last Name
3
Email Address* This field is required.
example@example.com
4
Phone Number* This field is required.
Please enter a valid phone number.
5
Business Name* This field is required.
6
Business Website
7
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
8
Best way to contact you
Email
Phone
Text
9
Preferred contact time
Morning
Afternoon
Evening
10
Type of business/entity
Please Select
Please Select
Sole Proprietorship
LLC
Partnership
S Corporation
C Corporation
Nonprofit
Not Yet Formed
Other
11
State where business is registered/operates
12
Year business started
13
Number of owners
14
Brief description of the business
15
Approximate annual gross revenue range
Please Select
Please Select
Under $50,000
$50,000-$99,999
$100,000-$249,999
$250,000-$499,999
$500,000-$999,999
$1,000,000 or more
Prefer not to say
16
Number of employees (including owner if applicable)
17
Services needed
Business Tax Preparation
Business Tax Planning
Bookkeeping / Accounting
Payroll
Business Formation / Entity Setup
Business Financial Education
Business Financial Planning
Business Credit / Financial Literacy
Business Insurance / Benefits
Other
18
Tax year(s) needing preparation* This field is required.
Current year
Prior year(s)
Multiple years
Other
19
Are any prior-year returns still outstanding?
Yes
No
Not sure
20
Have you received any IRS or state notices?
Yes
No
Not sure
21
Entity type* This field is required.
Please Select
Please Select
Sole proprietorship
Partnership
Corporation
S corporation
LLC
Nonprofit
Other
22
Are bookkeeping records or a profit and loss statement available?
Yes
No
Partially
Not sure
23
What tax issue or planning goal do you want help with?* This field is required.
Reduce estimated tax payments
Plan for business expansion
Optimize owner compensation
Review entity tax strategy
Prepare for a major transaction
Manage multi-state tax exposure
Other
24
Estimated current-year revenue
25
What major changes do you expect this year?
No major changes expected
Hiring employees
Opening a new location
Entering new states
Changing ownership
Buying or selling business assets
Raising capital
Other
26
Are your books currently maintained?* This field is required.
Yes
No
Partially
Not sure
27
What bookkeeping software do you use?* This field is required.
Please Select
Please Select
QuickBooks Online
QuickBooks Desktop
Other
None
28
How many months need cleanup?* This field is required.
29
How often do you need bookkeeping support?* This field is required.
Monthly
Quarterly
Annually
30
Do you currently have employees?* This field is required.
Yes
No
31
Current payroll provider
Please Select
Please Select
No current provider
ADP
Paychex
Gusto
QuickBooks Payroll
Square Payroll
Other
32
Number of employees* This field is required.
33
Payroll frequency* This field is required.
Please Select
Please Select
Weekly
Biweekly
Semimonthly
Monthly
Other
34
What payroll support do you need?* This field is required.
Payroll setup
Ongoing payroll
Both
35
Is the business already formed?* This field is required.
Yes
No
Not sure
36
Desired entity type* This field is required.
Please Select
Please Select
S Corporation
C Corporation
LLC
Partnership
Sole Proprietorship
Nonprofit
Other
37
State for formation* This field is required.
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
38
Has an EIN been obtained?* This field is required.
Yes
No
In progress
Not sure
39
What help do you need with the structure and setup?
Choosing the right entity type
Filing formation documents
Obtaining an EIN
Registered agent setup
Operating agreement or bylaws
State compliance requirements
Other
40
Primary financial goal* This field is required.
Please Select
Please Select
Increase profitability
Improve cash flow
Build reserves
Plan for expansion
Reduce debt
Other
41
Time horizon* This field is required.
Please Select
Please Select
0-6 months
6-12 months
1-3 years
3-5 years
5+ years
42
Business cash-flow concerns
Irregular revenue
Slow-paying customers
High operating expenses
Seasonal fluctuations
Large upcoming expenses
Insufficient working capital
Other
43
Retirement and planning needs
Owner retirement planning
Succession planning
Key-person planning
Employee retirement benefits
Personal financial separation
Other
44
Other financial goals
45
Do you currently have business credit?* This field is required.
Yes
No
Not sure
46
What is your primary goal?* This field is required.
Please Select
Please Select
Build business credit
Improve credit readiness
Separate business and personal credit
Access financing
Understand credit basics
Other
47
What kind of help do you need?* This field is required.
Understanding business credit
Improving credit readiness
Separating business and personal credit
Reviewing current credit profile
Other
48
What type of protection or benefits are you interested in?* This field is required.
General liability insurance
Professional liability insurance
Property insurance
Workers' compensation
Health benefits
Retirement benefits
Disability coverage
Key person insurance
Other
49
Number of employees* This field is required.
50
Do you already have coverage in place?* This field is required.
Yes
No
Not sure
51
By submitting this form, you confirm the information provided is accurate to the best of your knowledge and understand that this is an inquiry only and does not create an engagement or guarantee services.
52
Optional preliminary document upload
Drag and drop files here
Select files to upload
Max. file size: 10.0MB
Optional. Sensitive documents are not needed at this stage unless requested later.
Cancelof
53
Anything else you'd like us to know?
Optional final notes.
Should be Empty: