Name of person submitting this form? *

First Name

Last Name

Name of Business Owner(s)

First Name

Last Name

Name of Business Owner(s)

First Name

Last Name

Phone *

(###)

###

####

What is the address of the company? *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What service(s) are you interested in?

Please check all that apply.

1-hr Business Consultation ($150.00)

Get my Stuff Started - (Start a Business or Accounting Record)

Finance my Stuff (Assistance with getting my business financed.)

Organize my Stuff (Help with setting up my administration files, appointment calendars, etc.)

Maintain my Stuff (Bookkeeping Services)

Tax Planning

Tax Preparation

Business Consultation Retainer (Pay a monthly retainer to gain advice, direction and insight throughout the operations of your business.)

Bookkeeping Consultation Retainer (Pay a monthly retainer to call for advice or insight on the accounting procedures for your personal or business affairs.)

Payroll Services

How did you hear about us?

Destiny Talent, LLC

Arkansas Baptist College

QuickBooks Pro Advisor

Clay House Branding Firm

The PBSA™ Bootcamp

Center of Cultural Innovation

A Virtual Event

Silver Lining Capitol Management

SOPM

Facebook/Intragram/TikTok Ad

Google

Please select what identifies you best:

Full-Time Business Owner

Part-Time Business Owner

Full-Time Performing Artist

Part-Time Performing Artist

Full-Time Entrepreneur

Part-Time Entrepreneur

None of the above

Do you have any of the following insurance policies for your business? *

Check all that apply.

Workers Compensation Insurance

Casualty Insurance

Business Liability Insurance

I do not have business insurance

Other

What is the most important reason for contacting us for accounting services? *

Pay Employees

Send & Track Invoices

Send and Pay Bills

Track Sales Tax on Products

Organize Expenses

Organize Project Budgets

How does your business predominately make money? *

I sell products

I provide services

Something else

Could you please provide the company address for payroll checks if it differs from the address mentioned in earlier forms?

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Will employees have alternative options available besides direct deposit? *

Yes

No

Are fringe benfits offered to employees? (Check all that apply.) *

Pension

Profit-Sharing

Vacation Pay

Sick Pay

Company Paid Life Insurance

Company Paid Health Insurance

Meals

Travel Reimbursement

Does not apply

I am not yet registered with the (EDD). *

I am not registered.

I started my registration but did not complete it.