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The Alan Kemp Group
400 Continental Blvd., 6th Floor, Suite 117
El Segundo, CA 90245
Phone: 310-426-2344 Fax: 310-426-2756
email: customerservice@alankempgroup.com
www.alankempgroup.com

 

 
CLIENT PROFILE

Contact Person:

Name: Phone Numbers:
Address 1: Home:
Address 2: Office:
City: Fax:
St: Cellular:
Zip Code: Pager:
Social Security Number: Emergency:
Date of Birth:  

Business Information:

Name: Mailing:  
Address 1: Address 1:
Address 2: Address 2:
City: City:
St: St:
Zip Code: Zip Code:
Phone: Fax:
Backline:  

Type of Business:

Sole Proprietorship  
Initial Investment:
Contribution:
Partnership  
Number of Partners:
Partner Name:
Partner's Initial Investment:
Corporation  
Date of Corporation:
State of Corporation:
Corporation State ID#:
Corporate Officers:
No. of Shares Authorized:
Distributed Shares:
No. of Share Holders:

ID Numbers:

Federal ID No: State ID No:
Business SIC No:    

Business Activity:

Principal Business Activity:
Principal Product or Service:
Date Business Established:
 
Type of Accounts:  
Current Savings Money Market
Name of Banks:  
1.
2.
3.
Current / Beginning Balances:  
Cash:
Accounts Receivable:
Inventory:
Security:
Bonds:

Tax Returns - Last Filed:

1996 Fed: State:
1997 Fed: State:
1998 Fed: State:

List of Assets:

Description Date Incurred Balance

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The Alan Kemp Group
400 Continental Blvd., 6th Floor, Suite 117
El Segundo, CA 90245
Phone: 310-426-2344 Fax: 310-426-2756
email: customerservice@alankempgroup.com

© AKG 2000 All Rights Reserved

 

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