Intake Form – Individuals - Clark & Cassidy, Inc.

Name*

First Last

Email*

Mobile Phone*

We use an SMS texting service to stay in close communication with our clients, so it is important for us to have your mobile phone number.

Address*

Street Address Address Line 2 City State ZIP Code

How did you hear about Clark and Cassidy?

About You

Why are you looking to make a change or seeking the services of our firm?*

Are you self employed?*

Do you have rental properties?*

Do you have investments in more than one state?*

What was the total income reported on your tax return last year?

What was the federal taxable income reported on your tax return last year?

What is the #1 challenge you are dealing with today, that if we solved together, would create the biggest impact in your finances?

What are your expectations of our firm?

On a scale of 1 – 10 (10 being highest), how urgently important is it for you to get started, and why?*

Can you briefly tell us why?

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Phone

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