Business Information
Primary Contact Information
Responsible Party Name (person signing on behalf of the organization)
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Preferred communication type
*
Phone
E-mail
Text
Company Information
Company Name
*
Please type the complete, legal name of the company
DBA Name
*
Legal Address (for mail and banking)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you have employees besides yourself and your spouse?
Yes
No
Financial Information
Prior Year Gross Revenues
Estimate is ok if prior year accounting is not yet completed.
Prior Year Net Profit
Estimate is ok if prior year accounting is not yet completed.
Prior Year Salary Taken
Estimate is ok if prior year accounting is not yet completed.
Prior Year Owner Draws Taken
Estimate is ok if prior year accounting is not yet completed.
Current Year Estimated Gross Revenues
Current Year Estimated Net Profit
How much cash do you need to take from the business each year for personal expenses and investments?
Retirement Planning
Are you or your spouse currently participating in an employer-sponsored 401K program?
Yes
No
Are you or your spouse currently participating in a Solo-401K or SEP program?
Yes
No
Are you or your spouse currently funding an IRA or Roth IRA?
Yes
No
Is your company funding any of the above retirement plans directly?
Yes
No
Retirement plans can offer significant long-term tax advantages. Are you interested in exploring any of these options?
Yes
No
Health & Life Insurance
How are you currently covered with health insurance?
Employer-sponsored plan through another job
Private insurance through a broker
Marketplace insurance plan
Medicare
Business-paid plan
Not currently insured
How are you currently covered with life insurance?
Employer-sponsored plan through another job
Private insurance through a broker
Business-paid plan
Not currently insured
Are you currently utilizing a Healthcare Savings Account (HSA)?
Yes
No
Health plans can offer both short-term and long-term tax advantages. Are you interested in discussing these options?
Yes
No
Voting
How will decisions be made?
Equal voting power among members
Voting power proportional to each member's percentage of interest in the LLC
Distributions
How often will the company make distributions?
Please Select
Monthly
Quarterly
Semi-Annually
Annually
How did you hear about us?
How did you hear about us?
*
Current customer
Yelp
Google
Facebook
LinkedIn
Nextdoor
Referral from:
Acknowledgment & Signature
I confirmed that all information I entered here is accurate and true.
I allow Accent Financial Services to capture my sensitive data like personal id, government id, social security number (SSN), and other information.
I have read the terms and conditions and privacy policy of Accent Financial Services.
Date Signed
*
-
Month
-
Day
Year
Date
Organizer Signature
*
Submit
Submit
Should be Empty: