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First Name*

Last Name*

Company Name*

Address*

Address 2*

City*

State*
---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPuerto RicoPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Zip Code*

Phone*

Email*

Number of Employees*

Number of Sub-Contractors*

Payroll frequency*
---WeeklyBi-WeeklySemi-MonthlyMonthly
Who currently handles your payroll?*
---New BusinessIn HouseNot Currently ProcessingAccountant/Tax ProfessionalADPPaychexMyPayroll ClientMyPayroll EmployeeMyPayroll Tax ProfessionalMyPayroll Banking PartnerOther
Need a Tax Professional*
---No, thank you! I do my own taxesNo, thank you! I have a Tax ProfessionalYes, for payroll onlyYes, for payroll and tax preparationYes, for payroll, accounting & tax preparation
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