Customer Intake Form Step 1 of 3 - About You 0% Company InformationTell us about you.Company Name(Required) Employer Identification Number( EIN)(Required) The Employer Identification Number, also known as the Federal Employer Identification Number or the Federal Tax Identification Number, is a unique nine-digit number assigned by the Internal Revenue Service to business entities operating in the United States for the purposes of identification. Company Legal Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Company Phone(Required)Company Website Company Logo Drop files here or Select files Accepted file types: jpg, png, Max. file size: 20 MB. If your looking for Web Design or Creative services please provide your logo so we can use it in any mockups. Please make sure it's transparent in the PNG format.Authorized Contact InformationName(Required) First Last Email(Required) Phone(Required)Where did you hear about us?(Required)GoogleYahooBingYandexDuck Duck GoFacebookTwitter/XInstagramDigital BillboardSubway/TransportationDirect WebsiteHuluSamsung TV PlusParmount+ How Can We Help?What Services Are You Interested In?(Required) IT Services & Management Cybersecurity Web Hosting Web Design Voice Services 3CX Solutions Dialpad Ai Call Center Solutions Graphic Design Video Services Ideation Marketing SEO Digital Signage Social Media Management Office 365 Services Other/Not Listed Give us some Detail on your businessPlease provide some detail on your business and how we can be of service.Who Referred You? LegalConsent(Required) I agree to be contacted.I agree to allow Clark-Ritchotte Communications and Affiliated Companies to contact me by email, mobile phone, and text message regarding my Inquiry. I may withdraw my consent at any time by contacting Clark-Ritchotte Communications and Affiliated Companies using any means. I would also like to receive information from Clark-Ritchotte Communications and Affiliated companies regarding events, happenings, and new services. Clark-Ritchotte Communications and Affiliated Companies are collecting this personal information. It will not be used or disclosed for other purposes. I certify that I have read and fully understand the above statements and consent fully and voluntarily to allow Clark-Ritchotte Communications and Affiliated Companies to contact me. I also allow Clark-Ritchotte Communications and Affiliated Companies to use my logo in draft designs, mockups, etc. I also allow the use of said draft designs mockups in current and future marketing for Clark-Ritchotte Communications and Affiliated Companies.