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* 1. Please provide me with the following:

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* 2. Approximate number of employees/1099 contractors:

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* 3. My payroll frequency is:

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* 4. State(s) where our employees work:

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* 5. My current provider is:

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* 6. My current accounting software is:

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* 7. Were you referred by one of our referral partners? If so, please enter the discount code below:

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* 8. My Contact Information:

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