Tax Resolution - Basic Questionnaire
Customer Details:
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
example@example.com
What is your tax filing status?
Single
Married Filing Jointly
Married Filing Separately
Head of Household
Qualifying Widow
Do you have any dependents?
Yes - 1
Yes 2-3
Yes - 4+
No
What service are you interested in?
Individual Tax Relief
Self-Employed (Schedule C) Tax Relief
Business Tax Relief
Have all of your tax returns been filed timely?
Yes
No
What is your total tax liability (how much you owe the IRS)?
$10,000 or less
$10,000-$20,000
$20,000-$40,000
$40,000-$60,000
$60,000-$80,000
$80,000 or more
Have you incurred any penalties?
Yes
No
If you have incurred penalties, what is the total amount?
What notices have you received from the IRS, if any?
Have you received any liens/levies from the IRS?
Yes
No
If you have received liens/levies, how many and what kind?
Have you ever declared bankruptcy?
Yes - Less than 1 year ago
Yes - 1-5 years ago
Yes- 5+ years ago
No
How did you hear about us?
Friend
Family
Elite Tax Group
Facebook
Other
Additional Notes (Optional)
Submit
Should be Empty: