Roper Strategies CFO Services Request Form

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

Best Time of Day to Contact You:

Contact Time - First Choice
Contact Time - Second Choice
Contact Time - Third Choice
How did you find us?
If 'Referral', what is the referrer's name?
If 'Other', please explain.

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?
If 'Yes', state the # of new hires:
Do you have a Business Plan for growth?
Are your tax returns current?
If 'No', how many years behind are they?

Rate Your Business:

Below, please rate how often you review the following information in your business on a scale of 1 to 5, where 1 = rarely and 5 = frequently.

Monthly Financial Statements:
Financial Budgeting:
Gross Profit:
Accounts Payable:
Key Performance Indicators:
Cash Flow Projections:
Aged Accounts Receivable:
What other financial information do you use to monitor your business and help you make decisions?
Please give us a brief overview of your business goals.
Why is it important to you to have accurate financials? (Check all that apply.)
If Other, please explain.
Specifically, what services do you need from us? (Check all that apply.)
If you selected 'Other', please explain.
Anything else you would like to add or we should know?
OPTIONAL: Please feel free to attach any documents (business plan, copies of financials, etc.) you feel may also be helpful. PDFs only, please.