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  • 1475 S State College Blvd #112, Anaheim CA 92806

    Phone: 949-379-8558

    wwww.SemperTax.com

    Financial QA - Tax Relief 

    The answers you provide will help Semper Tax Relief "(STR") understand your current situation and allow STR to fully evaluate your resolution options. Please fill it out to the best of your ability.

    If something does not pertain to you, please fill with N/A. If you leave an item blank, we will treat it as if it does not apply to you. If you require additional space, please write an email with the information to: onboarding@sempertax.com

  • Section 1: Personal & Household Information

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  • Spouse Info:

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  • Section 2. Household Monthly Income

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  • Section 3: Monthly Household Living Expenses

    What Personal Expenses (Non business) Do you pay per month?
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  • Section 4: Personal Assets

  • A. Bank Accounts

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  • B. Cars / Vehicles Owned

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  • C. Investments Accounts (IRA / 401K/Stocks/Bonds)

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  • D. Real Property Owned

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  • Section 5: Reasonable Cause

  • By Electronically signing this financial QA, I declare that I have completed the foregoing information and accompanying schedule to the best of my ability. I acknowledge that the information herein is true, accurate and complete. Semper Tax Relief will review the information for a reasonable tax resolution matter based solely upon the financials and personal information provided. STR is under no obligation to verify the foregoing information or to provide any further information in connection with its services on my behalf. I understand and acknowledge that: (1) my tax resolution matter will be accepted or denied by the applicable government agency; (2) STR does not warrant or guarantee any particular outcome related related to its services ; (3) I have not relied on any statement by STR outside of those statements contained in the the documents presented to be STR; (4) STR has provided me substantial insight in regards to my matter that I would not have otherwise attained, and, as a result, I hereby agree to waive any and all claims to a refund of any sort whatsoever, in perpetuity, against STR for its services on my behalf and myself (“Dispute”), I hereby consent to binding arbitration pursuant to the rules of the American Arbitration Association (“AAA”) as the sole and exclusive manner in which I may resolve such dispute. I consent the County of Los Angeles , State of California as the sole and exclusive jurisdiction and venue for the arbitration. I shall be responsible for notifying STR of the dispute, and selecting 5 (five) prospective arbitrators who are members of AAA and who have had previous experience in matters similar to that of the dispute, from which STR may select one (1) arbitrator. The arbitrator will be entitled to, but not required to provide that the losing party in any arbitration will pay all or a portion of the prevailing party’s cost incurred in connection therewith including, without limitation the costs and fees of the arbitrator , provided, however, if the arbitrator declines to make such a decision, then the costs of the arbitration will be split equally between STR and myself (except that each party will bear its own attorneys fees). Any and all Disputes shall be governed by and construed and enforced by the law of the State of California, over any suit, action or proceeding initiated to enforce any arbitration award hereunder. I hereby irrevocably waive to the fullest extent permitted by law any objection I may have now or hereafter to such venue as being an inconvenient forum.

  •  Please review this Client Organizer to ensure that every question that pertains to your situation is filled out. If a question is left Blank, we will treat it as if it is not applicable to you.

  • Section 6: Signature & Date

    Under penalty of perjury, I declare that I have examined the information provided in this statement and all other documents included with this questionnaire, and that, to the best of my knowledge and belief, they are true, correct, and complete.
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