Personal Information
Full Name
*
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Basic Requirements
Are you legally to work in the United States?
*
Please Select
YES
NO
Are you 18 years of age or older?
*
Please Select
YES
NO
Do you have any experience with tax filing?
*
Please Select
YES
NO
Do you currently have an EFIN or PTIN number?
*
Please Select
YES
NO
BOTH
Do you have valid State ID/Driver License
*
Please Select
YES
NO
Additional Comments
Skills and Experience
please indicate if you have any of the following skills of training.
*
PTIN
EFIN
Tax software Experience
Tax Preparation
Bookkeeping
None
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature
Submit
Should be Empty: