New Tax Preparer Affiliate Enrollment Application

Tax Preparer Affiliate Enrollment Application
TO BEGIN THE APPLICATION PROCESS YOU WILL NEED THE FOLLOWING ITEMS:

1.) VALID DL OR STATE ID (NO EXPIRED IDENTIFICATION)

2.) SOCIAL SECURITY CARD

3.) PTIN LETTER

4.) EIN NUMBER

5.) DBA NAME/BUSINESS NAME

6.) BUSINESS ACCOUNT ROUTING & ACCOUNT NUMBER
Who Referred You/Or who is your Team Lead?
AFFILIATE INFORMATION
BUSINESS NAME*
EIN NUMBER*
AFFILIATES NAME (YOUR FULL NAME)*
SOCIAL SECURITY NUMBER*
DATE OF BIRTH*
ADDRESS (MUST BE A SHIPPING ADDRESS TO RECIEVE BANK SUPPLIES)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
PHONE NUMBER*
Please enter a valid phone number.
DRIVERS LICENSE NUMBER*
STATE OF ISSUE*
EXPIRATION DATE*
EMAIL*
example@example.com
PTIN#*
HAVE YOU BEEN CONVICTED OF A FELONY IN THE PAST 7 YEARS?*

YESNO
IF YES, PLEASE EXPLAIN
DO YOU CONSENT TO A BACKGROUND CHECK?*

YESN0
HAVE YOU EVER PREPARED TAXES BEFORE?

YESNO
IF YES, WHAT COMPANY DID YOU WORK FOR?
WHAT TAX SOFTWARE DID YOU USE?
WHAT IS THE REFUND BANK USED?
HOW MANY RETURNS DID YOU PREPARE?
ESTIMATE OF HOW MANY TAX RETURNS YOU WILL COMPLETE IN THE UPCOMING SEASON?
FEE DEPOSIT INFORMATION

MUST USE BUSINESS ACCOUNT PLEASE CONFIRM ALL NUMBERS ARE CORRECT TO ENSURE TIMELY PAYMENTS
BANK NAME*
TYPE OF ACCOUNT

CHECKINGSAVINGS
ROUTING NUMBER*
ACCOUNT NUMBER*
SIGNATURE - CONFIRMS THAT YOU HAVE REVIEW THE ABOVE SUBMITTED BANKING ROUTING AND ACCOUNT NUMER*

Clear
PLEASE UPLOAD YOUR DRIVERS LICENSE

Cancelof
PLEASE UPLOAD YOUR SOCIAL SECURITY CARD

Cancelof
PLEASE TAKE A PHOTO FOR CONTRACT AND SECURITY PURPOSES
My Products
prevnext( X )
AFFILIATE TRAINING AND SOFTWARE PAYMENT DUE UPON FIRST PAYOUT. THE AFFILIATE TRAINING FEE SPECIFIED IN YOUR CONTRACT WILL BE AUTO DEDUCTED FROM YOUR FIRST PAYOUT. (EXAMPLE: YOUR FIRST COMMISSION PAYOUT IS $15,000 AND YOUR SOFTWARE FEE IS $899; YOUR DIRECT DEPOSIT WILL BE $14,101.
$ Free Quantity

Total

$0.00
Should be Empty:

Tax Preparer Affiliate Enrollment Application

AFFILIATE INFORMATION

FEE DEPOSIT INFORMATION