| Person to contact:* |
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| Contact telephone #:* |
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| Email Address:* |
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| Type of Business: |
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| Last Years Sales: |
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| Estimated Sales this Year:* |
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| Number of checks written per month:* |
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| Number of deposits per month:* |
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| Number of W-2 Employees:* |
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| Number of 1099 workers:* |
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Do you use a payroll service?:*
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Yes No |
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| Name of Payroll Service:* |
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| Pay Periods (Check all that apply) : |
Weekly Bi-weekly |
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Semi-Monthly Monthly |
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| Do you track inventory?: |
Yes No |
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Do you currently use an accounting system?:
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Yes No |
| Name of Accounting System:* |
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| Additional Information or Questions: |
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