Hey there new client! Fill out this form and we’ll do our magic for your taxes & shit. General InfoLegal Name of BusinessDBAMain Contact (Legal Name) First Last Do You Have a Preferred Name? Yes No, I go by my legal name What Is Your Preferred Name?You can leave any of the fields blank if you need to. First Last Preferred Pronouns they/them she/her he/him not listed prefer to not disclose What Are Your Preferred Pronouns?Email PhoneWebsiteAddress Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date of Birth MM DD YYYY Key ContactsPlease list your key employees/contacts we may need to talk to along with their contact information.Business InfoWhat does your business do?Have you formed an LLC or a Corporation? Yes No Date of Incorporation MM DD YYYY Business TypeSole-Proprietor (unincorporated)LLC/LLPLLC, Taxed as an S-CorpPartnershipS-CorpC-CorpEINNo EIN I do not have an EIN Partners/ShareholdersFull Legal NamePreferred NamePreferred PronounsDate of BirthPercentage of Ownership No Partners It’s just me, I have no business partners Current Accounting SoftwareXeroQuickBooks OnlineWaveNothing/Something ElseInvite [email protected] as an advisor with permission to manage users I have completed this Invite [email protected] as an accountant I have completed this Invite [email protected] as an accountant with admin privileges I have completed this What are you using?Do you want Countless to prepare your taxes? Yes No Not Sure Do you have a tax accountant? Yes No What is their name or the firm's name?Which Method of Accounting do you use? Cash Accrual Not Sure Payroll and BenefitsAre you currently processing payroll? Yes No State(s) you have employees locatedDo you have a current payroll provider? Yes No Who is your current payroll provider?GustoADPPaychexQuickBooksSomething elseAdd [email protected] as accountant I have completed this Are you manually processing payroll yourself? Yes No Do you have a retirement account setup? Yes No Which type(s) of retirement account(s)? Roth IRA Traditional IRA SEP IRA 401k Something Else Do you have health insurance? Yes No Health insurance info My plan, paid from personal My plan, paid from the business On someone else’s plan It’s a health share plan Something else Sales Tax AccessAre you currently liable for sales tax or do you anticipate being liable for sales tax in the future? Yes No Present State(s) of Filing?Estimated Payments MadeHave you made any estimated tax payments so far this year? Yes No Have you made payments to the IRS? Yes No Details For IRS PaymentsPlease list out which quarter the payment was for, how much you paid, and the date of the payment. You can add more rows as needed. If the payment wasn’t made by the due date, you can list the quarter you intended the payment to be for. QuarterAmount PaidDate Paid Have you made payments to your state for personal taxes? Yes No Details For Personal State PaymentsPlease list out the state paid, which quarter the payment was for, how much you paid, and the date of the payment. You can add more rows as needed. If the payment wasn’t made by the due date, you can list the quarter you intended the payment to be for. StateQuarterAmount PaidDate Paid Have you made payments for any other income taxes (PTET, corp/biz, UBT, etc) Yes No Details For Misc. TaxesPlease fill in the taxing authority under agency (for example: NYC, Philly, CT, CA). Then fill in what the tax was for (for example: corp tax, PTET, UBT, NPT). In the remaining columns please list out which quarter the payment was for, how much you paid, and the date of the payment. You can add more rows as needed.AgencyFor WhatQuarterAmount PaidDate Paid NameThis field is for validation purposes and should be left unchanged.
