Diamond Elite
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BUSINESS OWNER TAX & PAYROLL INTAKE FORM
Business Owner Information
First Name:
Last Name:
Email:
Telephone:
Company Information
Company Name:
Federal EIN:
Company Address:
City:
State:
Zip:
Employee Information
Total Number of Employees:
Please indicate the number of each:
W-4 Employees (W-2):
1099-MISC Contractors:
1099-NEC Contractors:
Payroll & Tax Filing Questionnaire
We charge
$14.99
per employee to prepare required tax filing forms.
Do you need us to complete tax forms on your behalf?
Yes
No
Additional Payroll & Employee Questions
1. Do you currently run payroll?
Yes
No
2. How often are employees paid?
Weekly
Bi-Weekly
Semi-Monthly
3. Do you use a payroll service provider?
Yes
No
4. Have all employees completed a current W-4 form?
Yes
No
Some
7. Do you provide any of the following benefits?
Health insurance
Retirement Plan
None
Acknowledgment
I certify that the information provided above is true and accurate to the best of my knowledge.
Signature (draw below)
Clear
Undo
Sign Date: