Prospective Client Questionnaire

1
What prompted you to seek tax relief?* This field is required.(Select all that applies)
Received an IRS or State Notice
Garnishment, Lien or Levy
Unpaid taxes
Unfiled returns
Other
2
Have you received a Notice or Letter from the IRS or State Tax Taxing Authority?* This field is required.
Yes
No
Other
3
When Was The Notice or Letter Received?* This field is required.
Date
Month
Day
Year
4
My Wages Have Been Levied or Garnished* This field is required.
My Wages Have Been Levied or Garnished
I Have Received A Notice of Levy or Garnishment
None of The Above
Other
5
When Does/Did The Action Go Into Effect?* This field is required.
Date
Month
Day
Year
6
Do You Currently Owe The IRS or State Any Money?* This field is required.
Yes
No
I'm Not Sure
Other
7
How Much Do You Owe?* This field is required.
$5,000 & Under
$5,001- $10,000
$10,001- $25,000
$25,001- $50,000
$50,000- $75,000
$75,001 and Above
8
Do You Owe Federal or State Taxes?* This field is required.
Federal and State
Federal Only
State Only
Other
9
What Type of Tax Issues Do You Have?* This field is required.
Personal
Business
Personal and Business
Other
10
Are There Any Tax Returns Due That Have Not Been Filed?* This field is required.
Yes
No
Other
11
Which years are unfiled?* This field is required.
2023
2022
2021
2020
2019
2018 and/or older
Not Sure
Other
12
Do you have another problem that has not been addressed* This field is required.Select all that applies
Sales and Use Tax Issues
Payroll Tax Problems
Non-resident filing or tax issues
Expat tax filing or tax problems
None of these are my issue
13
Are you currently in bankruptcy?* This field is required.
Yes
No
14
When do you expect your bankruptcy to discharge?* This field is required.
1-2 Months
3-4 Months
5-6 Months
Not Sure
15
16
Based On Your Responses, You Qualify for a Free Initial Consultation. Tell Us How To Contact You* This field is required.
First Name
Last Name
17
By Phone
By Phone
By Email
18
Phone Number
Area Code
Phone Number
19
Email Address* This field is required.
example@example.com
20
I am providing express written consent to be contacted at the phone number provided and any other subscriber or user of this number by Legacy Tax & Resolution Services and/or its affiliates using automatic dialing systems and pre-recorded and artificial voice and text messages anytime from and after your inquiry, to discuss the products and services offered by its affiliates in response to your requests. I waive any registration to any state, federal, or corporate Do Not Call registry for purposes of such calls. I understand consent is not required to purchase goods or services and that message and data rates may apply.
I agree to these terms and conditions
21
I would be happy to help solve your tax problems. Give me a call at 855-829-5877 x203. I have set up a link to my Calendar - https://calendly.com/taxman/tax-problem-resolution-initial-consultation Let's set up a FREE 30 min. phone consultation to talk about your options.

Check out the review of 273 Tax Resolution Firms at https://www.legacytaxresolutionservices.com/about/tax-resolution-company-reviews, to help narrow down the potential firms

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22
Based On Your Responses, We Will Need To Wait Until Your Bankruptcy is Discharged. In the meantime, enter your contact information and we’ll send you our Bankruptcy Guide to Tax Relief.* This field is required.
First Name
Last Name
23
By Phone
By Phone
By Email
24
Phone Number
Area Code
Phone Number
25
Email Address* This field is required.
example@example.com
26
I am providing express written consent to be contacted at the phone number provided and any other subscriber or user of this number by Legacy Tax & Resolution Services and/or its affiliates using automatic dialing systems and pre-recorded and artificial voice and text messages anytime from and after your inquiry, to discuss the products and services offered by its affiliates in response to your requests. I waive any registration to any state, federal, or corporate Do Not Call registry for purposes of such calls. I understand consent is not required to purchase goods or services and that message and data rates may apply.
I agree to these terms and conditions
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