Elite Tax KingdomBank Enrollment Application

"Loyalty, Honesty, & Integrity With Just One Phone Call"

required Information for the bank application:

1. Name, email, and cell/home number of the office contact(s 2. Bank account information where you would like to have your prep fees earned to be deposited 3. If you are part of a service bureau, or chain of offices, you will need to have the Home/Main office's EFIN number for the release of the EFIN. 4. Copy of your previous year bank settlement price sheet. 5. SSN, Driver's License information, email, and cell number for the EFIN owner and all business

6. Business Tax ID number, if applicable 7. Copy of EFIN summary page from www.irs.gov Tax/Pros e-services 8. If not yet register, form W-9 can be found on www.irs.gov
CHECK MARK THE BANK YOU ARE APPLYING WITH

TPG SANTA BARBARA BANKTPSCEPSREFUND ADVANTAGEREPUBLIC BANK
Company Name
Dba Name
Address
City
State
ZIP
Phone

Area CodePhone Number
Fax
Tax ID
E Mail
example@example.com
EFIN
PTIN
Date Business Established

MonthDayYear
Date
Date Tax

MonthDayYear
Date
Preparation Began
Type of Business
Web Site URL
GUARANTOR/OWNER INFORMATION:
Guarantor/Owner Name
DOB
Contact Name
SSN
Address
City
State
Zip
Phone

Area CodePhone Number
Cell
DL Number
DL Exp Date

MonthDayYear
Date
Fax
Place of Issuance
Date of Issuance

MonthDayYear
Date
E Mail
example@example.com
PTIN
Owner Percentage
"Loyalty, Honesty, & Integrity With Just One Phone Call"

Account Type: Checking [] Saving [ Routing Transit Number (RTN): Depositor Account Number (DAN):
Account Type:

CheckingSavings
Routing Transit Number (RTN)
Depositor Account Number (DAN)
Name of Banking Institution
Name on Bank Account
Prior Year EFIN
Estimated # Tax Returns for the tax year
Prior Year Bank Products
Estimated # of Preparers for the tax year
Prior Year Software
Estimated # Bank Products for the tax year
Prior Year Processing Bank
# Checks Printed
# Debit Cards Issued
How many years have you owned this business
How many years have you been preparing taxes
PHYSICAL ADDRESS
SHIPPING ADDRESS
Physical Address

Address

Street Address Line 2

CityState

Postal / Zip Code
Physical Address Zip
Shipping Address

Address

Street Address Line 2

CityState

Postal / Zip Code
Shipping Address Zip
Has anyone associated with the company been assessed preparer penalties

YesNo
Has anyone associated with the company been convicted of a criminal offense

YesNo
Has anyone associated with the company been barred from practice before the IRS or US Tax Court?

YesNo
Is Company a licensed Money Services Business?

YesNo
Are there any administrative proceedings, governmental investigations/inquiries, or material litigation pending or threatened against the company?

YesNo
I Also Run These Businesses out of my Locations(SELECT UP TO 3)

Pawn ShopReal EstateAccountingFinancial PlanningCheck CashingTravel ServicesNotary ServicesInsurance
You can reach me by Email

YesNo
You can reach me by Text

YesNo
You can reach me by Phone

YesNo
The Best Method to reach me is:

TextPhoneEmail
My Preferred Language is

EnglishSpanish
This location is an office in my home

YesNo
This location is an office that is open all year

YesNo
Office has secured storage for card and check stock?

YesNo
Is the Location Company or Franchise owned

YesNo
Owner Name/ Printed
Owner Name/ Signed
Date

MonthDayYear
Date
Owner Name/Printed Please mail, fax or e-mail your completed agreement to: Elite Tax kingdom Attention: Software Master Agent 5560 NE 2nd Avenue Miami, FL 33137 Off. Phone: (786)361-0606 Cell Phone: (786)553-0178 Fax: (786)228-2861 E-Mail: elitetaxkingdom@gmail.com
Should be Empty:

GUARANTOR/OWNER INFORMATION:

PHYSICAL ADDRESS

SHIPPING ADDRESS