New Client Information Form
Client information provided on this form is authorizing Valencia Sims as your Tax Advocate. Be advised, the applicant must be operating an Estate/Trust or Business Entity, Agent ID and submit prior year tax return(s) transcript(s) and pay non-refundable fees, per year. Clients will receive an invoice from Valencia Sims who can be reached by Call/Text 678-755-9895 for inquiries Monday through Friday 9a to 9p. ( 3 ) Year Term Agreement.
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Dependents List ( use n/a if none ) *
Military Service Member or Spouse *
Mobile Phone Number *
Legal Name ( Agent/Owner ) *
Social Security Number ( Agent/Owner )  *
Date of Birth ( Agent/Owner ) *
Agent/Owner Title ( ex: CEO, Member, Trustee, etc ) *
Legal Name ( Co-Owner/Agent ) if applicable, n/a if not
Legal Name ( Partner/Agent ) if applicable, n/a if not
Entity Start Date *
MM
/
DD
/
YYYY
Entity Name ( Brand Name \ Doing Business As \ Estate Name\ Organization Name \ Trade Name \ Trust Name \ Stage Name \ NFT Name ) *
Entity Structure *
EIN Number ( IRS Employer Identification Number ) *
Mailing Street Address *
City *
State *
Zip Code *
E-mail Address *
Phone Number *
Estate/Trust and/or Business Description *
Website for Business
Product or Service Description
How many employees does this entity currently have? *
How much revenue did the entity spend paying bonuses, commissions, salaries or wages? *
How much revenue did the entity generate LAST YEAR? *
Did the entity take a revenue loss of 20% or more, compared to previous years? *
Does this entity have a bank account? *
Is this entity or its owners subject to back up / late tax withholding(s)? *
Referred By *
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