New Client Info Sheet — Gintz Warner CPA

Please complete the following information to establish a client account with us:

TAXPAYER

Name

First Name

Last Name

Legal Name

If different, please list your legal name

Business Name (if applicable)

Phone

(###)

###

####

What type of phone is this?

Email

Address

City, State, Zip

Birth Date

MM

DD

YYYY

SPOUSE

Name

First Name

Last Name

Legal Name

If different, please list your legal name

Business Name (if applicable)

Phone

(###)

###

####

What type of phone is this?

Email

Birth Date

MM

DD

YYYY

DEPENDENTS

Please list names and birth dates of all dependents...

COMMUNICATION PREFERENCES

General Communications

Tax Organizer Delivery

Tax Return Delivery

REFERRAL SOURCE

How did you hear about our firm?