Roper Bookkeeping Service Request Form

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Name*
Title*
Business Name*
Address
Contact Phone*
-
E-mail*

Best Time of Day to Contact You:

Contact Time - First Choice
Contact Time - Second Choice
Contact Time - Third Choice

Tell Us About You:

We want to understand your business so we can better meet your needs. Please tell us about you and your business.
# Years in Business:
NAICS Code
Current Annual Revenue ($)
Products/Services Sold:
Are you currently using QuickBooks?
If 'Yes', what version of QuickBooks?
If QuickBooks Pro/Premier, please specify the version year:
If QuickBooks Enterprise, please specify the version year:
Business Structure:
Employees/Contractors:
How many employees do you currently have?
How many contractors do you currently have?
Do you plan to hire in the next 12 months?
Are your tax returns current?
If 'No', how many years behind are they?
Expectations:
Why are you seeking a new bookkeeper?
How did you find us?
If 'Referral', what is the referrer's name?
If 'Other', please explain.
Where would you expect bookkeeping work to be done?
How often do you need bookkeeping services?
How frequently would you like to be in contact with your bookkeeper?
What are your expectations from your bookkeeper?

Services:

Specifically, what services do you need? (Check all that apply.)

Accounting Software Training/Setup
Small Business Services
Business Growth Services
Other
Services
Anything else you would like to add or we should know?