NEW TAX CLIENT INTAKE FORM
Get the max back with Top Tier Refunds. We promise to make this your BEST tax season yet!
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mobile Number
*
Can you receive text messages at this number? We send only 2-3 texts out each tax season to help keep you updated.
Yes
No
Email Address
example@example.com
Are you a U. S. Veteran? Veterans can save money on tax prep fees when filing with Top Tier Refunds.
Yes
No
How did you hear about us?
*
Please Select
Facebook
Instagram
TikTok
Flyer
Yard Sign
Google
Yelp
Referral
Other (Please specify...)
Other
*
Will you be willing to recommend us?
Yes
Maybe
No
We pay $100 per referral! Please give reference of any two people whom you feel deserve extraordinary customer care this tax season.
Full Name
Contact Number
Email Address
1
2
Choose your preferred Tax Professional you would like to work with this tax season.
Please Select
I do not have a preference
Tamara Van Buren
Nilisha Jelks
Lakisha Kelly
Meghan Johnson
Jacqueline Taylor
Corey Dixon
Teri Blaydes
Submit
Should be Empty: