Business intake

  • Business Intake Form

    PLEASE FILL OUT ALL INFORMATION APPLICABLE
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  • Format: (000) 000-0000.
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  • Format: (000) 000-0000.
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  • This form is for intake purposes only!

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  • Authorization for Direct Deposit

  • AUTHORIZATION FOR DIRECT DEPOSIT STATEMENT: I hereby authorize A Tax LLC to initiate automatic deposits to my account at the financial institution named below. I also authorize A Tax LLC to make withdrawals from this account in the event a credit entry is made in error.

    I agree not to hold A Tax LLC responsible for any delay or loss of funds due to incorrect or incomplete information supplied by me or by my financial institution or due to an error on the part of my financial institution in depositing funds to my account.

    This agreement will remain in effect until A Tax LLC receives a written notice of cancellation from me or my financial institution, or until I submit a new/updated direct deposit form to Human Resources.

  • Account Information

  • Account Information
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  •  I understand that this information is needed to process my request for assistance.   AR Financial and/or A Tax Services will not be held liable for any associated penalties, audits, or fines as it relates to compliance.

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