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Client Intake Form
PERSONAL INFORMATION
First Name
*
Middle Name
Last Name
*
Home Address
*
Apt. No.
City, Town or Village
*
Province
*
Postal Code
*
Telephone No.(Home)
Work
Cell
Fax
Email
*
Occupation
*
Employer
*
DOB (MM/DD/YEAR)
*
FAMILY INFORMATION (IF APPLICABLE)
Spouse
First Name
Middle Name
Last Name
Do you have children?
*
Do you have children?
A
Yes
B
No
Name
Age
Name
Age
COMPANY INFORMATION (IF APPLICABLE)
Do you have an existing company?
*
Do you have an existing company?
Yes
No
Name of Company/Companies
Location of Minute Book
ACCOUNTANT INFORMATION
Accountant's Name
Firm
Accountant's Email
Accountant's Phone Number
How did you hear about us?
Agreement
*
Agreement
I agree that Arcus Legal may store and make use of the information I have submitted on this form, for the purpose of providing the legal services I have requested.
Submit
