NEW CLIENT INTAKE FORM

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 NameLast Name
Address*

Street Address

Street Address Line 2

CityState / 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.

YesNo
Email Address
example@example.com
How did you hear about us?*
Are you a U. S. Veteran, First Responder, or Teacher? If you select yes, you can save money on tax prep fees when filing with Top Tier Refunds.

YesNo
Other*
Will you be willing to recommend us?

YesMaybeNo

We pay $100 per referral! Please give reference of any two people whom you feel deserve extraordinary customer care this tax season.

Choose your preferred Tax Professional you would like to work with this tax season.
Should be Empty:

NEW TAX CLIENT INTAKE FORM