Contact Information
Business name:
Business address:
Website URL:
Primary contact:		*
Business phone:
Cell phone:
Email address:		*
Confirm email:		*
Industry:
Life sciences	Pharmaceutical	Software/internet
Real estate	Telecommunications	Medical device
Hospitality	Other:
Briefly describe your business:
Number of owners/partners:
What is the long-term business strategy?
Maintain ownership         Initial public offering         Merger/acquisition         Not sure
For new companies, what is the estimated start date?
For existing companies, what is your planned implementation timeline for an accounting solution?
Accounts Payable (Purchase to Pay)
Approximately how many accounts payable transactions occur each month?
1-50         50-100         100-200         200+         N/A
What are the names of primary vendors critical to business operations?
Accounts Receivable (Order to Cash)
How do you bill customers?
Direct mail invoice
Email invoice
Credit card/online payment
ACH (automatic electronic fund transfer)
Do you require customer advance payment?
Yes        No        N/A
Do you have post-contract customer support services?
Yes        No        N/A
Do you provide a warranty for products or services?
Yes        No        N/A
Briefly describe your return policy:
Approximately how many accounts receivable transactions occur each month?
1-50         50-100         100-200         200+         N/A
Company Financing
What form of capital funding will be used to start or grow the business?
Venture capital/angel investing         Bank loan         Personal loan
Anticipated amount of funding required for one year of operations:
Less than $250K
$250-$750K
$750-$1.5M
More than $1.5M
Not sure
Do you plan on taking out a line of credit with a financial institution in the next two years?
Yes        No        Not sure
Payroll and Employee Benefits
Number of employees for the next year of business:
Salaried employees	Hourly employees
1-5	1-5
5-15	5-15
15-25	15-25
25+	25+
Do you currently use a payroll processing service (e.g., Paychex, ADP)?
Yes        No        N/A
Do you plan on issuing options or restricted stock as part of an employee incentive program?
Yes        No        N/A
What types of benefits are offered to employees?
Medical (e.g., PPO, HMO)
Dental
401K plan
Health savings plan
Inventory
Do you have standing inventory or will you in the future? Generally, if you produce, purchase, or sell merchandise in your business, you must keep an inventory and use the accrual method of accounting.
Yes        No        N/A
Information Technology (IT)
What type of internal software is used by your business?
Accounting (e.g., QuickBooks, PeachTree, MAS 90)
Microsoft Office
Adobe Acrobat
Other:
Do you currently utilize any of the following computer hardware systems?
Web server	Virtual private network
Email server	Network/backup storage
Application server	Other:
Reporting
Will you require tax-reporting services?
Yes        No        Not sure
Do you anticipate requiring a financial statement audit within the next two years?
Yes        No        N/A
Do you anticipate needing a company valuation within the next two years (e.g., 409A valuation)?
Yes        No        N/A