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PNW Advisors Prospect Business Client Questionnaire (PART 1)
1.
Please provide your business contact information.
Primary Contact Name
Company Legal Name
Street Address
Address 2
City/Town
State/Province
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code
Country
Email Address
Phone Number
2.
Please provide your website address. (Type N/A if not applicable).
3.
Best day/time to contact:
Date / Time
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Hour
Time
:
Minutes
AM/PM
-
AM
PM
4.
Please indicate your business industry?
Medical/Healthcare
Optometry
Professional Service Based
Other (please specify)
5.
Number of employees? (Type N/A if not applicable).
6.
What is the annual revenue for your business?
7.
Name of previous CPA or Tax Advisor? (Type N/A if not applicable).
8.
Any additional notes or special comments about your business?
9.
How did you hear about our firm?
Referral by another client
Website
Other Advertisement
Google
Other (please specify)
10.
If referred by another client, then please provide referral client name.
Current Progress,
0 of 10 answered