REQUEST FOR FINANCIAL AND ACCOUNTING SERVICES

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Thank you for choosing VisionQwest's Financial Services.

SERVICE/S REQUIRED* (Check all those that apply.)  Bookkeeping    Tax Preparations    CFO Services  Payroll    Business Start-Up    Compliance & Fraud Services  Management Services    Consulting Services    HR Services

CONTACT INFORMATION Name* Company Name*

Company Address*

City/Province* State* Zip code*

Phone no.* Fax no. Mobile no.

E-mail address* Website URL

CORPORATE INFORMATION Organization Type*  Corporation  Partnership  LLC  Sole Proprietorship Other, Pls specify  Years in business*

Date Incorporated State Organized at

FIN no. SSI no.

President/Owner's Name Contact no.

PAYROLL INFORMATION (answer if applicable) How is your Payroll done? WeeklyBimonthlyMonthly Payroll In-charge

Number of Employees Do you have 1099 Staff? General & Administrative Staff YesNo Sales If yes, how many are they? Manufacturing/Production Other Department Other PR information Total Number of Employees Total Average Monthly PR $

BOOKKEEPING INFORMATION (answer if applicable) Are you reporting on a In accounting, do you use Last year taxes filed  Calendar year Fiscal year  Accrual Basis Accounting Cash Basis Accounting

Number of A/P Transactions Average $

Number of A/R Transactions: Average $

Number of Bank Accounts When Last Reconciled

Average Yearly Sales $ Other information you think are relevant: Average Cost of Sales $ Average Net Income $