CORPORATE INTAKE SHEET
GENERAL INFORMATION
__________ Corporation __________ LLC
__________ For-Profit __________ Non-Profit
1. Name of Corporation:
2. Structure of Entity
Investors ___ Yes ___ No
If yes, two classes of shares? ___ Yes ___ No
3. Name(s) of Incorporator(s):
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4. Current status:
______ New Corporation to be organized for new business
______ Merger of conversion of existing entity into new corporation
______ Need to organize already formed corporation
______ Need to maintain already organized corporation
Notes:
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5. State of organization: _______________________________________________
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6. Date of organization: ________________________________________________
7. Principal address of corporation in state of organization:____________________
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8. Name and address of agent for service of process:
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9. a. Name and address of corporation's accountant:
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___ Put a plug in here for xx, business and personal accountant in Irvine.
___ Request authorization to provide their contact info to xx.
___ E-mail xx with their info.
b. Do you have a set plan to save for retirement and minimize your annual tax liability?
Talk about xx, xy, or xz and how they can help with
1. retirement planning, life insurance for personal
2. emergency planning, life insurance for business (buy/sell);
3. help you meet your personal financial goals.
10. Name and address of corporation's insurance agent:
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a. General Liability Insurance
b. Work Comp Insurance
c. Business Auto Insurance
d. Products Liability Insurance
e. Professional (errors and omissions/malpractice) insurance
f. Medical Insurance:
11. Foreign qualifications/principal address in qualified state(s):
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12. Name(s) and address(es) of agent(s) for service of process in qualified state(s):
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13. Shareholders:
% of # of Cash capital Other
Name: ownership: shares: contribution: contribution:
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Conflict of Interest Disclosure: __________________________________
Written waiver needed: yes ______ no
Buy-Sell Agreement needed: ______ yes ______ no
Notes: ___________________________________________________________
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14. Vesting of Shares:___________________________________________________
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15. Family Trust Name:___________________________________________________
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*Put in Plug for xx.
__ Hand them xx’s business card.
__ Follow up with client at document signing.
16. Directors:
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17. Officers:
President: __________________________________________________
Secretary: __________________________________________________
Chief Financial Officer: _______________________________________
Vice President: ______________________________________________
Other: _____________________________________________________
Other: _____________________________________________________
TAX AND ACCOUNTING CONSIDERATIONS
1. Federal ID No: ____________________________________________________
2. S Corp.: _______________ OR C Corp.: _______________
3. For S Corp:
Shareholder Names: Shareholder SSNs:
_____________________________ _____________________________
_____________________________ _____________________________
_____________________________ _____________________________
Spouse Names: Spouse SSNs:
_____________________________ _____________________________
_____________________________ _____________________________
_____________________________ _____________________________
6. Fiscal year end:
7. Projected number of employees (w/in 12 months):__________________
a. Would you like to know your payroll is being handled correctly for a low monthly fee? Talk about xx, at ADP or xx, at Paychex. The Firm works with Paychex.
______ What company are they currently with, if any?
__ Obtain client’s authorization for xx to contact them.
__ Call/e-mail xx with client’s contact information.
__ Follow up on document signing.
b. Would you like to save time and money by using a temp agency to find good employees/independent contractors for you? Or for H/R assistance.
___ Yes ___ No
c. Employment Contracts/employee handbooks – refer to employment attorney
__ obtain authorization to provide contact info to atty.
__ Call/e-mail atty with that info.
__ Follow up with client at document signing.
d. Medical Insurance
__ Would you like to know that you are paying a good price for a good medical insurance policy for your employees? .
8. Compensation of officers/directors:
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BUSINESS PLANNING MATTERS
1. Description of business/financial projections:
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__ Talk with client about the capital required to get their business to the next level.
__ Discuss xx (business banker), xy (bank)
__ Obtain authorization for banker to contact them
__ Call/E-mail banker with client’s information
__ Follow up with client at document signing
__ E-mail Schedule of Assets/Liabilities
2. Assets/liabilities to be assigned:
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___ Discuss any equipment the client has or would like to purchase, refer to business banker.
3. Locations/Leases:
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___ Discuss the client’s desire to purchase a commercial location for their business, refer to business banker.
4. Agreements:
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5. Fictitious Business Name Statement and/or Abandonments:
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6. Trademark Registration/Service mark Registration: _______________________
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___ Discuss intellectual property attorney.
7. Website:
Domain Name: ____________________________________________________
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Creator/Maintenance Information: _____
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REGULATORY MATTERS
1. Permits/Licenses:
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2. Insurance Policies:
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OTHER NOTES:
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