The CPA Group, PC - New Client Intake Form

Full Name*

Phone Number*

Email*

City*

State*

Date of Birth*

Were you referred to a specific accountant?*

Yes

No

I was referred to:*

Who referred you?*

Reason(s) for switching Accountants*

First time usage of a CPA

Moved to the area and need new CPA

Cost of previous accountant

Used an online software and would rather have a local professional

Need a second opinion

Previous accountant no longer in business

Other

Please describe your reason for switching.*

Reason(s) for your inquire:*

Individual Income Tax Services

Business Income Tax Services

Estate or Trust Tax Return Services/Consultation

Individual Advisory Services

Business Advisory Services

Payroll Services and Software

Bookkeeping Services and Software

Financial Statement Preparation

Audit of Financial Statements

Other Services

Are you married?*

Yes

No

Do you have any dependents?*

Yes

No

Have you filed all previous year tax returns?*

Yes

No

How many years behind are you.*

Less than 3 years behind

More than 3 years behind

What type(s) of income do you receive?*

Wages W-2

Interest/Dividends

Retirement

Self-employment

Rental/royalty income/K-1

Unemployment

Foreign income

Other income

Describe your other individual income.

What is your average annual income?*

Less than $50,000

$50,001 to $100,000

$100,001 to $250,000

$250,001 to $500,000

$500,001 or more

What is the name of your business(es)*

What does your business sell or services it performs?*

What is the estimated annual gross revenue of your business?*

Less than $50,000

$50,001 to $125,000

$125,001 to $300,000

$300,001 to $800,000

$800,001 to $1,500,000

$1,500,001 to $3,000,000

Greater than $3,000,001

How do you track your revenue and expenses?*

QuickBooks Online

QuickBooks Desktop

Spreadsheet(s)

Paper/hand calculated summary

I don't have a system

Other method or software

Describe how you track revenue and expenses.

Do you have employees?*

Yes

No

How many employees do you have?*

How do you calculate and pay your employees?*

QuickBooks Online Payroll

QuickBooks Desktop Payroll

Third Party Payroll (Gusto, ADP, Paychex, Etc)

Other Payroll Software

By Hand or Spreadsheet

I need help with payroll

Have you filed all previous years business tax returns?*

Yes

No

How many years behind is your business?*

Less than one year

Two to four years

Greater than four years

Please indicate the type of individual assistance*

Tax planning and compliance

Estate planning

Retirement planning

Philanthropic planning

Financial life planning

Please indicate the type of business assistance*

Business formation and registration

Tax planning and compliance

Budgeting and forecasting

Mergers and acquisitions advisory

Financial planning and analysis

Succession planning

Employee benefit plan consulting

Please indicate the type of payroll assistance*

Outsourced payroll processing

Payroll tax filings

Employee benefits administration

Garnishment processing

Payroll system implementation and support

Payroll reporting and analytics

How many employees do you or will you have?*

What is your payroll payment frequency?*

Please indicate the type of bookkeeping assistance*

Outsourced revenue and expense tracking and classification

Accounts payable management

Bank and credit card reconciliation

Fixed asset management and depreciation

Payroll integration

Sales tax reporting and compliance

Financial reporting

Setup of electronic bookkeeping system

Please indicate the type of estate or trust assistance*

Estate or trust tax return preparation

Consultation regarding an estate or trust

Need assistance obtaining an ID number

Please indicate the type of financial statement preparation assistance*

Balance Sheet

Income Statement

Cash Flow Statement

Footnotes

Consolidated Financials

Financial Statement Analysis

Interim Financial Statements

Review Financial Statement Engagement

Management Report and/or Dashboard

Please indicate the type of entity for which the audit needs to be performed.*

School District

Political Subdivision

Small Municipality

Other

Please describe the other type of other entity?

Please describe in detail the other services for which you are seeking assistance.

Are you interested in paying for services via a simplfied monthly payment agreement?*

Our Professional Service Agreements were developed to give our clients a straightforward payment method for annual services. Through these agreements, we can bundle our services and offer you a regular monthly payment for our services.

Yes

No

New Client Intake Form

Please complete the following questionnaire to assist us in evaluating your request.

Individual Income Tax

Business Income Tax

Individual Advisory Services

Business Advisory Services

Payroll Services

Bookkeeping Services

Estate or Trust Returns or Consultation

Financial Statement Preparation