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Client Update Form – Business

Business Name
Updated Contact Information
Home phone:
Cell phone:
Work phone:
Best Email For Confidential Information:
Indicate Preferred E‐mail for Client Portal
Name:
Title:
Email:
Business Attorney:
Name:
Email:
Phone:
Property and Casualty Insurance Agent:
Name:
Email:
Phone:
Group Benefits Insurance Agent:
Name:
Email:
Phone:
Payroll Service Provider:
Provider/Rep:
Email:
Phone:
Business Succession:
Is there an existing buy‐sell agreement in force? YesNo
For one person owned companies, do you have a succession plan if you pass away? YesNo
Are shareholder/partnership agreements in place and up to date? YesNoN/A
Do you have a sense of what your business is worth? YesNo
Property and Casualty Insurance:
When was the last time you had your property and casualty insurance reviewed/shopped?
Do you have Business Interruption Insurance in place? YesNo
Do you have Employment Practice Liability in place? YesNo
Health Insurance, Life and Disability:
Do you provide health insurance for your employees? YesNo
What percentage do you cover for your employees — single and family plans?
When was the last time you had your health insurance and benefits reviewed/shopped?
Do you have key man life insurance in place? YesNo
Please provide details below if applicable:
Company Type (Term, Whole, etc.) Length (years) Death Benefit Owner Beneficiary Annual Premium Amount
Do you have disability insurance on key owners? YesNo
Do you have group disability policies for employees? YesNo
Retirement Plans:
What type of retirement plan do you currently have in place?
If not applicable, are you interested in putting a retirement plan in place in the near future? YesNo
Are you looking for options to put away more retirement monies for key owners? YesNo
Other Questions:
List the states where you transact business in and may have a physical presence (time spent, employees, inventory, rent, etc.):
State Describe Activity
Does your company perform any internet fulfillment/on‐line orders? YesNo
Are you content with your current accounting software set‐up and are you receiving adequate monthly internal financial reports? YesNo
Do you have a disaster recovery plan in place to protect your IT infrastruture? YesNo
We have a very strong network of professionals to assist with all of your financial needs. Feel free to list below any areas where you might want advice and/or resources made available:

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