DIY WISP

Notes before using form.

The form will take 10-20 minutes to complete.
If you do not know the answer to a question, please select “ I don’t know.”
If you have any “ I don’t know” answers, you will be able to ask a WISP technician to assist you after you fill everything out.
Selecting “Fail” does not automatically disqualify the WISP itself from being compliant.
The information needs to be accurate & truthful.
After the form is completed, a WISP specialist will use the information provided and generate an IRS compliant WISP and deliver to you via email.
It takes us 1-3 business days to take this information and create a WISP.
You only need to submit this form once, we can update pieces you need help with or correct later.

Create WISP Intake Form

Step 1 of 7

Your Company Name *

Include LLC, PA, etc. If a DBA, put the DBA name.

Company Owner Name *

First

Last

Email *

Phone *

Name of Person or Company Doing This Audit *

I attest under the penalties of perjury and potential loss of license that all answers on the document will be correct and accurate as of the time of creating this document. *

Inventory

List all devices that contain taxpayer data. This includes not only social security numbers and banking information, but even email addresses. The form supports up to 5 devices, if you use less than 5, just leave the extras blank. If the devices are in the same location, you need to re-type the same address in each device location address box.

Device 1 Name *

Device name for audit. Primary computer or server.

Device 1 Location Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Use 2 letter state code (FL vs Florida)

Device 2

List information about the 2nd device that holds taxpayer data. If you do not have a second device, then leave this blank and proceed to next page.

Device 2 Name

Device 2 name for audit. Leave blank if there isn't another device.

Device 2 Location Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Use 2 letter state code (FL vs Florida)

Tagged DIY-WISP, Silver

877-572-6989

Inventory

Device 2

Device 3

Device 4

Device 5

Device 6

Device 7

Device 8

Device 9

IRS - Taxes Security Together: Security Six

IRS Publication 4557: Safeguarding Taxpayer Data

Secure Wireless Networks

WISP Requirements

IT Company Contact Information