First Name
*
Last Name
*
EMAIL
*
1. How did you hear about us?
*
Facebook
Instagram
LinkedIn
Tiktok
Google
Twitter
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2. What are your main business concerns ultimate goals?
*
3. How do you believe we can help?
*
4. What is your filing status?
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Single
Married
5. What is your marginal tax rate?
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0.10
0.12
0.22
0.24
0.32
0.35
0.37
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(What tax bracket do you fall in? Refer to the above chart, find your net income in the right column and then select your % in the box below, which will be to the left of that same row)
6. What forms do you file for your business?
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Schedule C
1040
1065
1120
1120s
Other
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Please specify (if any other)
7. Does your spouse work in the business?
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Yes
No
8. Business Name
*
9. What state do you file your individual state tax returns?
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Alaska
Alabama
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10. In what state is your business operating?
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Alaska
Alabama
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11. What is your percentage of ownership?
*
12. What services you provide?
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Design
Software Development
Sales/Marketing
Business Development
Videography
Coaching/Consulting
Other
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13. Is this a specified service?
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Yes
No
14. How many employees do you have?
*
15. How many business owners are there for this business?
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16. How many businesses do you own?
*
17. How many years have you been in business?
*
18. What is your business entity?
*
1040
1065
1120
1120s
Other
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Please specify (if other)
19. What is your current annual gross revenue?
*
$
20. What is your current annual net revenue?
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$
21. What was your estimated amount paid in taxes this previous year?
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$
22. How much was your approx. salary for the previous tax year or expected for this year from your business?
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$
(If you do not pay yourself a salary enter 0)
23. What was your approx. previous year W2 income?
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$
24. What was your approx. taxable income?
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$
(If you worked for someone this would be W2- Enter 0 if no taxable income)
25. What is the approx. amount of income that is subject to self employment tax if any?
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$
(Enter 0 if no self employment tax)
26. What is the approx. amount of capital gains income if any? (Gains from Investments)
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$
(Enter 0 if no capital gains income)
27. Did you take the home office deduction last year?
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Yes
No
28. What is the approx. amount of qualified business property if any?
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$
(Any buildings/land - Enter 0 if none)
29. Did you deduct for meals on your previous tax returns?
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Yes
No
30. Do you have any children; Do you take care of parents that live with you?
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Yes
No
31. Do you currently contribute to a retirement plan?
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Yes
No
32. Are you open to having meetings in your home if it would provide you tax savings?
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Yes
No
33. Do you do any research and development?
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Yes
No
34. Do you pay more than 50K for insurance per year?
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Yes
No
35. Do you own any buildings?
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Yes
No
36. Do you offer benefits to your employees?
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Yes
No
37. Did you purchase a vehicle or any equipment this year that you use for your business?
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Yes
No
38. Were there tips paid in your business?
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Yes
No
39. Your Total Estimated Tax Savings
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40. Since last year, you paid the above amount in taxes. If this year looked similar, what portion of that would you ideally want working for you inside a Private Wealth Strategy?
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$
41. CPA Authorization Code
*