Quality Tax Customer Dispute Form

Quality Tax Customer Dispute Form
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Quality Tax Employee Full Name

First NameLast Name
Quality Tax Employee Position
Date of Incident

MonthDayYear
Date
Time of Incident
Details of Incident
What is Your Desired Solution to Resolve Your Dispute
Would you like a face to face meeting?

YesNo
Is it okay to resolve complaint by phone?

YesNo
Should be Empty: