Nomotax Questionnaire

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

Please enter a valid phone number.

4

Phone Number

Please enter a valid phone number.

5

Do you have a birth certificate within one of the 50 States?* This field is required.

YESNO

6

Are you employed & have a current paycheck stub within the last 30-60 days?* This field is required.

YESNO

7

Are you a W-4 or 1099 employee?* This field is required.

YESNO

8

Do you earn an annual income of $20K or more?* This field is required.

YESNO

9

Are you a government employee of any kind currently including any branch of the Military, Navy, Air Force, U.S. Coast Guards, FBI, Department of Homeland Security, CIA, ATF, WHO, Department of Veterans, NSA, Department of Defense, Department of Transportation, Department of Agriculture, Securities and Exchange Commission, Department of Education, etc.?* This field is required.

YESNO

10

Were you born in Puerto Rico, Guam, American Samoa, Virgin Islands, Dominican Republic, or the Commonwealth of Mariana Islands?* This field is required.

YESNO

11

Are you a U.S. citizen that went through the Naturalization Process to live in the United States?* This field is required.

YESNO

12

Are you a Permanent Resident with a current green card?* This field is required.

YESNO

13

Are you a U.S. Person or a Resident Alien Individual?* This field is required.

YESNO

14

Are you an asylum seeker or refugee from any foreign country?* This field is required.

YESNO