SECTION I (All Organzations)
Organization Type:	County/County Related Entity Municipality Municipal Department/Fund Housing Authority School Activity/Cafeteria Fund(s) Utility District Other Government Accounting Firm Nonprofit Organization
Municipality/County Name: (If Municipal/County Department/Fund):	( )
Organization's EIN: (Employer Identification Number- Accounting Firms do not have to complete this question)
Organization's Legal Name:
Organization's DBA Name: (Does Business As name)
Mailing Address:
	City:  State:
	Zip:
Primary Fiscal/Organization Contact Person/Title:
Telephone Number of Contact Person: (Please include area code)	Ext.
Organization's Primary E-mail Account: (or Organizational E-mail Account of Principal Contact)
NO PERSONAL E-MAIL ACCOUNTS, PLEASE.   Confirmation of form submittal will be sent to this e-mail address as well as any future e-mails.
Maximum E-mail Capacity: (maximum file size)
SECTION II (Accounting Firms Only)
Does the firm maintain offices at multiple locations?	Yes   No  (If NO, Skip the remainder of section II)
Does each office contract separately for all audits conducted at that office?	Yes   No
Is the office identified in Section I designated as the main office where all correspondence should be sent?	Yes   No  (If YES, mark next question N/A)
Main office information: Mailing Address:
	City:  State:
	Zip:
Contact Person/Title:
Phone Number:	Ext.
E-mail Address:
Maximum E-mail Capacity (maximum file size)
SECTION III (All Organizations)
Name/Title of Person Completing Form:
Date:
Comments:
Upon submission of this form you will receive an e-mail confirming all the information entered above. The e-mail will be sent to the e-mail address entered in Section I, Question number 7 above. If you have questions concerning this form, please call the Division of County Audit at: (615) 747-7841, Division of Municipal Audit at: (615) 532-4460 or e-mail us at ma.web@tn.gov.