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Last Name: Required
Company Name: Required
Telephone Number: Required
Fax Number:
Street Address:
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Email Address:
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What accounting and/or bookkeeping services do you need? (check all that apply)
Basic bookkeeping recording deposits, checks, bank reconciliation
Full charge bookkeeping services including invoicing, bill pay and reporting
Bank reconciliations and Financial Reporting
Special clean up project
Dont know
All of the above

How soon would you like to begin your accounting and/or bookkeeping services?
ASAP
In 1 month
In 2 months
In more than 2 months

What is your estimated budget for this accounting/bookkeeping project?
$500 - $1,000
$1,000 - $2,000
$2,000 - 5,000
$5,000 - 10,000
$10,000 - 20,000
$20,000 - 50,000
$50,000+

How often do you need a bookkeeper?
Daily
Weekly
Bi-weekly
Monthly
Quarterly
Not sure

What kind of software do you use?
QuickBooks Pro
Peachtree
MYOB
PC Law
Other
None

Where do / can the bookkeeping services be performed?
On-site
Remote log in
Doesnt matter

How soon would you like to begin your bookkeeping services?
ASAP
In 2 weeks
In 1 month
In more than 1 month

What is your estimated MONTHLY budget for this bookkeeping project?
$200 - $500
$500 - $1,500
$1,500 - 3,000
$3,000 - 5,000
Please indicate any special needs or requirements here:
 



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Cigna Communications Group

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